Background: Many studies have explored the correlation between waist circumference and risk of hyperuricemia. However, few studies relating neck circumference (NC) with serum uric acid levels exist. This study aimed to explore the association between NC and risk of hyperuricemia in Korean adults over 40 years old. Methods: Data from 4,481 adults (≥40 years old) who participated in the 2019 Korea National Health and Nutrition Examination Survey (2019 KNHANES) were used for this study. The data were analyzed using t-and chi-square tests with SPSS complex samples. The odds ratios (OR) and 95% confidence intervals (CI) of hyperuricemia based on NC and multiple confounding factors were calculated using logistic regression analysis. We used three models with progressive degrees of adjustment. Model 1 was adjusted for only NC. Model 2 was further adjusted for age, aerobic physical activity, current smoking, and binge drinking. Model 3 was further adjusted for dyslipidemia, high density lipoprotein, hypertension, and HbA1c. Results: Model 1 showed positive correlation between NC and the risk of hyperuricemia (OR, 1.16 [95% CI, 1.09-1.22] for male and 1.25 [95% CI, 1.17-1.33] for female). We demonstrated similar results from Model 2 (OR, 1.14 [95% CI, 1.08-1.21] for male and 1.26 [95% CI, 1.17-1.34] for female) and Model 3 (OR, 1.12 [95% CI, 1.05-1.19] for male and 1.17 [95% CI, 1.09-1.26] for female) after adjusting for confounding factors. Conclusion: Neck circumference is positively associated with hyperuricemia in both genders over 40 years in terms of data from the 2019 KNHANES.