Gout is an inflammatory condition of the joints caused by deposition of crystallized monosodium urate (MSU) in the joint which leads to Arthritis. there are many debates about the suitable pharmacological therapy for the acute inflammatory gout attacks. The Pharmacological treatment included colchicine, non steroidal anti- inflammatory (NASIDS) and corticosteroid injection. The aim of this study is to review the evidences which studied the effect of Colchicine, NASID and corticosteroid injections and discuss their effectiveness in treating the acute flares of Gout. After evaluation the validity of the latest best evidences presented in the database by using the AMSTAR tool. There was no best drug and no optimal dose identified in treating acute Gout attacks. Doctors should be careful in selecting the treatment considering the side effect of each medication and deal with each patient individually to provide the best health care.