We treated a 62-year-old man with intermittent polyarthritis whose neck pain was prominent. Progressive deformities, limited neck motion, and the appearance of subcutaneous nodules prompted his admission to the hospital. The diagnosis of gout was established; the erosive and destructive changes in C6-7 were believed to be due to gout as well. Cervical spine involvement, although rare, can occur in gout. © 1987, American Medical Association. All rights reserved.