Tophaceous gout is a crystal arthropathy and a disorder of purine metabolism characterized by monosodium urate crystal deposition. Most of the patients are asymptomatic in the inter-critical period. Gout mostly affects the small joint of the foot. Large joints like knee may be affected by gout but its arthroscopic picture has not been widely reported in the literature. We here present a case of tophaceous deposits in the knee joint found out on diagnostic arthroscopy confirmed as gout by histopathological examination of synovium and comparison of the present case with existing literature.