AIM: Gout is a common complication in kidney transplant recipients. This study evaluated the association between kidney transplant recipients and the long-term risk of incident gout. METHOD: For this age-matched and sex-matched retrospective cohort study, the Catastrophic Illness Certificate Database and the National Health Insurance Research Database were combined between 1997 and 2010. The study included 5917 patients with kidney transplants and 23 668 matched kidney transplant-free subjects. Hazard ratio (HR) for risk of incident gout was calculated using the Cox proportional hazards regression. RESULTS: In this study, of the 5917 kidney transplant recipients, 521 (8.8%) had gout. The kidney transplant group had a higher risk of incident gout than those in the matched kidney transplant-free group (adjusted HR = 1.55, 95% confidence intervals [CI] = 1.36-1.77), particularly within 3 years following kidney transplant recipients (adjusted HR = 2.61, 95% CI = 2.13-3.20). We observed that at the >3 to 6 years and the >6 to 9 years follow-up, patients with kidney transplant did not have a significant association with risk of incident gout (adjusted HR = 0.92, P = 0.4806 and adjusted HR = 1.26, P = 0.1901, respectively). CONCLUSION: These findings revealed that risk of incident gout increased within 3 years following kidney transplant recipients and the individual's long-term risk of incident gout between kidney transplant recipients and the general population remained similar.