Objective To compare the diagnostic value of X-ray, CT and MRI for the diagnosis of gouty arthritis. Methods The imaging data (X-ray, CT and MRI) of 116 patients with gouty arthritis confirmed by clinical practice who were treated in internal medicine department of the hospital from March 2017 to March 2018 were collected. The detection rate and imaging findings were compared among the three imaging methods. Results A total of 241 affected joints were diagnosed in 116 patients. The detection rates of gouty arthritis by X-ray, CT and MRI were 53.11% (128/241), 73.86% (178/241) and 88.38% (213/241) respectively. The detection rates of gout nodules, articular sub-capsular changes and soft tissue swelling in the affected joints by X-ray were significantly less than those by CT and MRI (P<0.05). There was no significant difference in the detection rates of gouty joints and articular sub-capsular changes between CT and MRI (P>0.05), and the detection rates of joint effusion and soft tissue swelling by CT were significantly less than those by MRI (P<0.05). Conclusion Three imaging methods of X-ray, CT and MRI all have high clinical value for the diagnosis of gouty arthritis. MRI has higher diagnostic value in gouty arthritis compared with X-ray and CT.