The purpose of this study is to describe the changes in the age-standardized prevalence rate, incidence rate, and years lived with disability (YLDs) rate for gout disease and the associated risk factors in 21 North Africa and Middle East (NAME) countries from 1990 to 2019 based on age, gender, and socio-demographic index (SDI). From 1990 to 2019, the Global Burden of Disease (GBD) team performed a comprehensive systematic review of databases and disease-modeled analysis in the NAME countries. Age-standardized prevalence, incidence, and YLD rates, as well as the attributed burden to risk factors (high body mass index (BMI) and kidney dysfunction), were reported with 95% uncertainty intervals (UIs). The age-standardized YLDs estimated in 2019 and 1990 were 14.2 (95% UI 8.9-20.4) and 15.8 (10.0-22.7) per 100,000 populations, respectively, with an increase of 11.7% (7.1-16.4%) from 1990. The health indicators were all reported to be higher among males. The three countries with higher SDI that had the highest age-standardized YLDs rate in 2019 were Qatar (22.5 [14.5-32.7]), the United Arab Emirates (20.5 [12.9-29.9]), and Kuwait (19.0 [11.7-27.6]), while YLDs in 2019 attributable to high BMI and kidney dysfunction were estimated to be 7.2 (3.8-12.2) and 3.7 (2.3-5.5) per 100,000, respectively. According to our findings, the burden of gout in the NAME is higher than the reported global average and has risen from 1990 to 2019. Despite advances in gout treatment, NAME countries should prioritize preventive interventions to manage the disease's burden. Gout is the most common type of inflammatory arthropathy, and there have been no specific reports of this disease burden in the NAME countries, which account for nearly 8% of the global population. This report estimated that age-standardized YLDs increased by 11.7% (7.1%-16.4%) from 1990 to 2019 in this region. Consequently, these countries have to prioritize preventive interventions to manage the disease's burden.