Background: Gout is a chronic inflammatory disorder stemming from metabolic dysfunction, characterized by the accumulation of monosodium urate crystals in joints and soft tissues due to prolonged hyperuricemia. Clinically, it often manifests with abrupt onset of intense joint pain, erythema, swelling, and tenderness, particularly in the small joints of the lower extremities such as the first metatarsophalangeal joint, ankles, and knees. In its chronic form, gout can lead to the development of tophi—firm nodular deposits of urate crystals— resulting in joint deformities, limited mobility, and systemic complications affecting the renal and cardiovascular systems. This case report describes the integrative management of a 68-year-old male patient with a long-standing history of chronic tophaceous gout, presenting with acute exacerbation involving multiple joints and extensive tophaceous deposits. The patient underwent a course of traditional Mongolian medical treatment, incorporating bloodletting therapy (hanuur), soaking therapy (devteeleg zasal), and phytotherapeutic remedies. Conclusion The treatment yielded notable clinical improvements: cupping therapy facilitated the reduction of joint inflammation and edema, alleviated pain, and enhanced peripheral circulation during the acute phase. Soaking therapy using medicated decoctions was effective in softening and reducing the size of tophi, promoting wound drying, restoring joint mobility, and improving overall functional capacity. The patient reported a marked enhancement in quality of life following the integrative treatment course. This case highlights the potential of traditional Mongolian medical interventions as adjunctive or alternative therapeutic strategies for managing severe gout, particularly in cases refractory to conventional pharmacological treatment. Further clinical research and controlled studies are warranted to validate these findings and to explore the broader application of traditional therapies in gout management.