Objective To analyze the current status and influencing factors of dietary restriction burden in patients with gouty arthritis during urate-lowering therapy, and to provide a basis for formulating nursing interventions. Methods A total of 204 patients with gouty arthritis receiving urate-lowering therapy were selected by convenience sampling. They were assessed using the general information questionnaire, the Burden Scalein Restricted Diet (BIRD), the Intuitive Eating Scale-2 (IES-2), and the Knowledge-Attitude-Practice Scale for Dietary Control in Patients with Hyperuricemia and Gout. Results The patients scored (25.52±4.87) points on the BIRD, (52.00±8.58) points on the IES-2, and (77.67±10.58) points on the Knowledge-Attitude-Practice Scale. The BIRD score was negatively correlated with the scores of the IES-2 and the Knowledge-Attitude-Practice Scale (r=-0.287,-0.232, both P＜0.05). Multiple linear regression analysis showed that age, educational level, receipt of dietary guidance, follow-up after medication, intuitive eating, and knowledge-attitude-practice were influencing factors of dietary restriction burden (all P＜0.05). Conclusion Patients with gouty arthritis experience a moderate level of dietary restriction burden during urate-lowering therapy, which is affected by multiple factors. Clinically, attention should be focused on young patients and those with low educational levels. Interventions such as improving intuitive eating concepts, strengthening knowledge-attitude-practice education on dietary control, and improving follow-up and dietary guidance should be implemented to reduce dietary restriction burden.