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In this study, we investigated the risk of thyroid cancer in patients with gout. Participants ≥40 years old in the Korean National Health Insurance Service–Health Screening Cohort were investigated. A total of 5844 patients with thyroid cancer were paired with 23,376 comparison participants (no history of thyroid cancer) to build the nested case–control study. A previous history of gout was collected from both the thyroid cancer and comparison participants. The relationship of thyroid cancer with a prior history of gout was analyzed using a conditional logistic regression model. The rate of gout was higher in the patients with thyroid cancer than in the comparison group. In the total study population, the relationship of thyroid cancer with a prior history of gout was not statistically evident. A previous history of gout was related to an increased risk of gout in the <60 years old, normal weight, abnormal blood pressure, and CCI score = 0 groups. The occurrence of thyroid cancer was not associated with a prior history of gout in the general adult population. However, a prior history of gout was related to an elevated risk of thyroid cancer in middle-aged and healthy populations without comorbidities. [ABSTRACT FROM AUTHOR]