Aim To explore the association between cardiometabolic index and hyperuricemia risk in people over 45 years of age in China Health and Retirement Longitudinal Study. Methods Data from the China Health and Retirement Longitudinal Study in 2011 and 2015 were included in this prospective cohort study. The 2011 data were used as the baseline and the outcomes of hyperuricemia were followed up in 2015. The Cox proportional hazard model was used to analyze the association between cardiometabolic index and the risk of hyperuricemia. ROC curve was used to analyze the predictive value of cardiometabolic index for the risk of hyperuricemia. Results Among 3 002 subjects, after adjusting for relevant confounders, the risk of hyperuricemia in the highest cardiometabolic index group was 3.12 times (P＜0.001) that in the lowest cardiometabolic index group in males, and HR was 3.0,5%CI was 1.606～6.062; in females was 2.128 times (P＜0.05) that in the lowest cardiometabolic index group, respectively, and HR was 2.8,5%CI was 1.060～4.272; the risk of hyperuricemia increased with the increase of cardiometabolic index. ROC curve analysis showed that the curve of cardiometabolic index for predicting the risk of hyperuricemia was 0.618 (95%CI:0.580~0.656), the best cutoff value was 0.433, the sensitivity was 46.97%, and the specificity was 72.94%. Conclusions The cardiometabolic index is positively correlated with the risk of hyperuricemia. Maintaining a low cardiometabolic index is beneficial to prevent hyperuricemia. It is suggested that cardiometabolic index may be an identification factor of hyperuricemia.