Abstract： Mitochondrial homeostasis refers to the dynamic equilibrium of mitochondrial quantity， morphology， and function within cells. Imbalance in mitochondrial homeostasis plays a key role in the onset and progression of gouty arthritis （GA），manifesting as dysfunction，oxidative stress，abnormal dynamics，mitochondrial DNA release，and autophagy. Gout is one of the common clinical metabolic diseases. Chinese medicine posits that its pathogenesis is rooted in spleen deficiency. On one hand，spleen deficiency can lead to insufficient generation of qi and blood，resulting in malnourishment of tendons，bones，and joints— "pain due to malnourishment." On the other hand，spleen deficiency can lead to endogenous production of damp-turbidity pathogens. When damp-turbidity struggles with blood stasis， it obstructs joints and meridians— "pain due to obstruction." An increasing number of studies have found that various Chinese medicine compound formulas and monomers based on the theory of "deficiency， turbidity， and stasis" can exert therapeutic effects on GA through mitochondrial pathways. This article，based on research related to mitochondrial homeostasis and integrating the Chinese medicine theory of "deficiency，turbidity，and stasis，" explores the pathological mechanisms of GA and the strategies for its prevention and treatment with Chinese medicine.