Dietary modification is frequently recommended for patients with gout. Longitudinal observational studies have shown a clear inverse relationship between low-fat dairy intake and gout risk. Several checkpoints in gout pathogenesis may be targeted by dairy intake. Cross-sectional and short-term intervention studies of healthy volunteers have demonstrated that low-fat dairy intake has a moderate urate-lowering effect. In addition, certain dairy fractions, particularly glyco-macropeptide and G600 milk fat extract, have anti-inflammatory properties in experimental models of acute gout. Such anti-inflammatory properties may contribute to the reduction in gout risk through inhibition of the inflammatory response to monosodium urate crystals within the joint. Well-controlled intervention studies in patients with gout are now needed to determine the clinical relevance of these observations in order to guide dietary recommendations for this disease.