One patient had acute, recurrent, sacroiliac gouty arthritis, and two others had clinically inactive, tophaceous involvement of the sacroiliac joint. In a retrospective roentgenographic study, changes characteristic of gout were found in the sacroiliac joints of seven of 95 gouty patients. Equivocal changes were found in an additional five gouty patients. Involvement was found only in patients in whom other manifestations of gout had been present for many years. Gout of the axial skeleton appears to be more frequent than is commonly thought.