Background: Upper endoscopic screening of cirrhotic patients reveals several gastric findings besides portal hypertensive gastropathy (PHG). These findings contribute to more than 20% of upper gastro-intestinal bleeding. The role of Helicobacter pylori (H pylori) and other lesions associated with PHG is debatable. Objectives: to describe the spectrum of lesions in the gastric mucosa in patients with portal hypertension, and to correlate the presence of H pylori with the risk of bleeding and serum gastrin level. Materials and methods: The study included fifty patients who met the inclusion criteria. Upper endoscopy was performed on all of them, and biopsies were taken from the stomach and were examined by histopathology. Results: Among the 50 patients, 20% had non-variceal bleeding. White light endoscopy (WLE)'s most common documented finding was PHG. According to histopathology, each of the biopsies obtained yielded multiple histopathological findings H. pylori was found in 88% of the patients, followed by Gastric antral vascular ectasia (GAVE) (56%) then PHG and gastritis (54 %). Only H. pylori correlated with the presence of PHG. Conclusion: Biopsy is recommended in cirrhotic patients during endoscopy to tailor treatment accordingly. In PHG, H. pylori treatment is recommended to decrease chances of bleeding.