Hyperuricaemia, or elevated serum uric acid (SUA) level, is a risk factor for comorbidities such as cardiovascular diseases, chronic kidney diseases, metabolic syndrome, type 2 diabetes and gout. The metabolism of purines, particularly xanthine oxidase, plays a central role in uric acid production. With a growing incidence of hyperuricaemia and gout, it is needed to identify new non-pharmacological treatments for reducing hyperuricaemia. Scientists have identified substances from natural sources, such as caffeine and others. A significant amount of this stimulant is found in coffee. In the past years, the consumption of coffee has increased significantly, and studies have been conducted to determine whether coffee is safe to use and how it can act on SUA levels. The effect on SUA also depends on dose and how the coffee is prepared; for example, roasted coffee contains lactone derivatives that may contribute to its xanthine oxidase inhibitory properties, while its diuretic effects could enhance renal uric acid clearance. This chapter reviews mechanisms for inhibiting xanthine oxidase and inducing renal uric acid excretion of caffeine and other bioactive compounds. Moreover, coffee consumption associations with insulin sensitivity and anti-inflammatory properties also will be mentioned. Furthermore, the chapter will review published studies that have reported an association between regular coffee intake and the risk of hyperuricaemia and gout. It will also discuss safe coffee consumption doses.