Background Musculoskeletal ultrasound is a useful, noninvasive tool to detect anatomical damage in the hyaline cartilage, synovial tissue, and tendons of individuals with asymptomatic hyperuricemia. This study aimed to determine the frequency of musculoskeletal ultrasonographic findings related to hyperuricemia among CKD patients and its relation to chronic musculoskeletal pain and their quality of life. Results Double contour (DC) was found in12%,18%, and 22% of the knee, ankle, and 1st MTPs joints, respectively. Hyper-echoic cloud was present in 2% and 6% of the knee and 1st MTPs, respectively. Synovitis was seen in 8%, 4%, and 16% of the knee, ankle, and 1st MTPs joints, respectively. Patellar tendon showed enthesopathy in 14% and tophus in 8% of cases. Tibialis posterior tenosynovitis was in 2% and peroneii tenosynovitis in 2%. Achilles tendon showed calcific foci in 24%, enthesopathy in 20%, and tophi in 4%. First MTPs showed erosion in 10% and tophi in 4%. There were statistically significant relations of pain index to DC, synovial thickening at the knee and at ankle joint. There were statistically significant relations of serum uric acid level to DC.There were statistically significant correlations of serum uric acid level to the 36-Item Short Form Survey (SF-36). Conclusions Untreated hyperuricemia might cause musculoskeletal ultrasonographic changes that could cause chronic musculoskeletal pain and decrease quality of life in chronic kidney disease patients.