BACKGROUND: Hyperuricemia is a well-established risk factor for renal and cardiovascular diseases, as well as a key contributor to gout, and its levels are influenced by meteorological conditions. OBJECTIVE: This study aims to investigate the relationship between the Universal Thermal Climate Index (UTCI), uric acid (UA) levels, and the risk of hyperuricemia. METHODS: A retrospective analysis was conducted on data from 211,327 participants who underwent health examinations at Taizhou Hospital, Zhejiang Province from 2019 to 2023. The analysis primarily examined the associations between UTCI, UA levels, and hyperuricemia prevalence. RESULTS: A total of 209,826 participants were included in the study, with a hyperuricemia prevalence of 18.4 %. The prevalence of hyperuricemia was significantly higher in males (31.5 %) compared to females (3.4 %). The mean UA level in males was 387.5 ± 82.6 μmol/L, significantly higher than in females (287.2 ± 64.7 μmol/L). UA levels in males showed a gradual decline with age, reaching their lowest point in individuals aged over 65 years (351.9 ± 87.3 μmol/L). Conversely, UA levels in females increased with age, peaking in those aged over 65 years old (312.9 ± 75.0 μmol/L). Month and season had a significant influence on UA levels (P <
0.001), with the highest levels observed in August and summer, and the lowest levels in January and winter. Furthermore, the analysis revealed a positive correlation between increasing UTCI classes and elevated UA levels and hyperuricemia risk. At UTCI class 9, the risk of hyperuricemia increased by 1.722-fold in males (P = 0.001) and 1.997-fold in females (P = 0.002). CONCLUSION: The UTCI classes are strongly associated with UA levels and hyperuricemia risk. As a comprehensive biometeorological indicator, UTCI demonstrates substantial potential for predicting UA fluctuations. These findings provide valuable insights into the pathogenesis of hyperuricemia, aiding in the development of personalized prevention and management strategies.