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Hyperuricemia, a common metabolic disorder, arises primarily from excessive uric acid production or impaired excretion, resulting in abnormal elevation of uric acid in extracellular fluids and tissues. Sustained hyperuricemia is closely linked to the development of gout, kidney diseases, and cardiovascular disorders. To date, hyperuricemia pathogenesis remains incompletely elucidated, with key challenges in animal model selection, therapeutic drug characterization, and the development of emerging treatments. Notably, increasing research attention has focused on traditional Chinese medicine (TCM) has gained growing research interest due to its unique advantages in treating hyperuricemia via holistic regulation and multi-targeted mechanisms. This review synthesizes these key topics, aiming to inform in-depth investigations into hyperuricemia pathogenesis, animal model optimization, and the development of TCM-centered emerging treatment strategies.