Aim of the work:  Helicobacter pylori infection is a major health problem because about 50% of all humans worldwide are infected with Helicobacter pylori. Portal hypertensive gastropathy (PHG), a term used to describe the endoscopic appearance of gastric mucosa with a characteristic mosaic-like pattern with or without red spots is a common finding in patients with portal hypertension. The role of H. pylori infection on PHG severity is controversial so we try to prove if there is any role of H. pylori infection and severity of PHG. Patients and methods: eighty consecutive patients with HCV-related liver cirrhosis were enrolled in the study. Diagnosis of H. pylori infection was done by detection of H. pylori Ag in the stool by ELISA test. 80 consecutive patients with HCV-related liver cirrhosis were enrolled. Patients and Methods: all patients were subjected to an upper gastrointestinal endoscopy and ELISA test of H. pylori Ag in the stool. The diagnosis and the severity of portal hypertensive gastropathy (PHG) were evaluated on doing endoscopy. Child-Pugh and MELD scores were calculated to assess the severity of liver cirrhosis. Results: H. pylori infection was reported in 46 patients with overall prevalence 57.5%. PHG was found in 57 patients (71.25%); 36 (63.15%) of them had mild and 21 (36.15%) had severe PHG. H. pylori was more prevalent among patients with PHG than those without PHG (57.5% vs. 42.5%; p<0.001). No significant relation was found between H. pylori infection and severity of liver cirrhosis as regards Child-Pugh score (p= 0.383) and MELD score (p= 0.666). Conclusion: our results showed a significant association between H. pylori infection and the occurrence and also the severity of PHG in patients with HCV-related liver cirrhosis. Yet, the severity of liver cirrhosis itself did not correlate with H. pylori or the severity of PHG. Thus, eradication of H. pylori may be beneficial to ameliorate PHG.