Tophaceous gout is a chronic form of gout with the formation of uric acid crystalline masses deposited in the soft tissues of numerous regions of the body. Various factors can influence the formation of the nodular masses called tophi, which differ in size and can involve many years of ongoing gouty arthritis. Tophus formation, among others, may end with ulceration of the skin, infection, deformities and mechanical impairment, with many cases serving as direct indications for surgery. Treatment involves pharmacological control of uric acid levels, prevention of infection and methods of surgical removal of tophi depending on stage of the disease and accompanying complications. This case report discusses a local 69-yearold patient with a long history of tophaceous gout with giant tophus on the injured elbow, leading to a rare indication for surgical intervention due to the wound severity.