Background: Gout is one of the most common rheumatic diseases and hypertension is one of the common comorbidities of gout. The combination of hypertension with metabolic abnormalities is of great importance. The development of gout is associated with obesity-induced metabolic abnormalities however a substantial number of non-obese patients also develop gout. Objective: to determine the association between hyperuricemia, obesity and hypertension. Method: A total of 200 Saudi patients who underwent health examination at outpatient clinic of rheumatology in Hussain Al-Ali hospital, were selected and divided into obese and non-obese groups for determining the relationship between serum uric acid, obesity and hypertension. Result: systolic, diastolic blood pressure and BMI were significantly higher in cases than in controls. Obesity and hyperuricemia were associated with higher risk for hypertension, where the odds ratio for obese gouty patients was 4.36 (95% CI: 1.90 – 9.96, p < 0.001) and 2.87 (95% CI: 1.16 – 7.11, p < 0.01) for non-obese gouty patients. Linear regression analysis showed that both blood pressure and serum uric acid were significantly (p < 0.001) associated with BMI. The prevalence of hypertension was (27.5% vs 16.25%, p < 0.001) in obese and non-obese groups in comparison to the control group respectively. Conclusion: This study supported the association of both obesity and hyperuricemia with hypertension. Showing that obese gouty patients have higher risk for developing hypertension than non-obese and both have higher risk than controls.