Gouty arthritis is a metabolic disorder characterized by elevated uric acid levels and urate crystal deposition, commonly in the first metatarsophalangeal joint. This cross-sectional study compared dietary, genetic, and lifestyle factors influencing gout severity among 82 patients. Results showed that 85% of non-vegetarians had significantly elevated uric acid levels (>10 mg/dL), compared to 15% of vegetarians. Over 70% of non-vegetarian patients displayed genetic variants. Non-vegetarians experienced more acute gout attacks, higher pain severity, and increased tophi formation. Conclusion: A non-vegetarian diet is associated with higher uric acid levels and more severe gout, while a vegetarian diet is linked to fewer attacks and reduced medication needs.