In chronic tophaceous gouty arthritis, the treatment may be very difficult due to eroding, replacing and absorbing articular cartilage, deforming arthritis, and fibrous ankylosis by deposition of sodium urate crystals. We reported two cases of chronic tophaceous gouty arthritis which were satisfactorily treated by arthroscopic chondroplasty, debridement of the pannus of granulation tissue and urate salts in the joint, as well as excision of tophi around the joints.