Gout is a health condition that can be managed to prevent morbidity and premature mortality. Māori have a higher prevalence of gout yet are less likely to receive appropriate care than non-Māori. There is scant literature presenting the patient/whānau voice relating to the health system response to gout. The study reported in this article aimed to highlight barriers and enablers in achieving best practice management of gout as defined by patients in order to inform the development of appropriate pathways and services. Using a Kaupapa Māori approach, interviews were undertaken with 23 participants as part of a multi-layered intervention to improve the management of gout for Māori.