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Introduction: Gouty tophi represents an uncommon outcome of prolonged gout. The urate crystal deposition in soft tissues characterizes it. They can present as tender, soft tissue masses, mimicking benign growths. Elbow tophi are uncommon but can cause significant morbidity. Case Report: A 65-year-old man with a history of chronic gout came in with noticeable swelling on the outer side of his right elbow. The swelling was firm in consistency, nonfluctuant, and mildly tender. Radiological and Histopathological investigations confirmed the diagnosis of tophaceous gout. A successful surgical excision was performed with uneventful post-operative results. Conclusion: This case study emphasizes the significance of suspecting tophaceous gout in individuals presenting with significant, unexplained swellings, especially in patients with a known history of gout. Prompt recognition and proper treatment are essential to avert further complications.