['Chronic hyperuricemia is responsible for a relevant burden of articular diseases and cardio-nephrometabolic disorders. We evaluated the effect of high serum uric acid (SUA) levels on hospitalization risk and mortality and on healthcare costs in a real-life setting.', 'We conducted a retrospective analysis using a large administrative database and a clinical registry among 112,170 subjects from three Italian local health units. Individuals were divided into four groups according to their SUA levels: <6\xa0mg/dL (66.5%), >6\xa0mg/dL and ≤7\xa0mg/dL (19.3%), >7\xa0mg/dL and ≤8\xa0mg/dL (8.7%), and >8\xa0mg/dL (5.5%). Compared to those with SUA level of <6\xa0mg/dL, the risk of hospitalization related to gout and/or nephrolithiasis was higher in the three groups of patients with higher SUA levels (1.51, P\xa0=\xa00.100; 2.21, P\xa0=\xa00.005; and 1.17, P\xa0=\xa00.703, respectively). A similar trend was also observed for hospitalization due to chronic kidney disease (CKD) (1.31, P\xa0<\xa00.001; 1.40, P\xa0<\xa00.001; and 2.18, P\xa0<\xa00.001, respectively) and cardiovascular disease (CVD) (1.08, P\xa0<\xa00.001; 1.23, P\xa0<\xa00.001; and 1.67, P\xa0<\xa00.001, respectively) and for all-cause mortality (0.97, P\xa0=\xa00.309; 1.21, P\xa0<\xa00.001; and 2.15, P\xa0<\xa00.001). The mean annual healthcare costs were higher in patients with higher SUA level (€2752, €2957, €3386, and €4607, respectively) mainly because of a progressive increase in hospitalization costs per patient (from € 1515 for SUA <6\xa0mg/dL to € 3096 for SUA >8\xa0mg/dL).'] Is hyperuricemia associated with increased hospitalization risk and healthcare costs : Evidence from an administrative database in Italy?