Background: The discovery of H pylori in 1983 by Marshall and Warren and establishment of its role in gastroduodenal ulcers and gastric neoplasms has caused a paradigm shift in the understanding and management of these diseases. In 1994, H pylori has been classified by WHO as a group I carcinogen. Subjects and Methods: This work comprises two separate arms the first one, a prospective study with the aim of estimating the prevalence of Helicobacter pylori among a group of Egyptian patients presenting with upper gastrointestinal symptoms and to delineate the common symptoms and endoscopic findings that might be associated with Helicobacter pylori infection. The second arm of this work, a retrospective epidemiological study involving the analysis of the endoscopic findings of patients presented to the gastrointestinal endoscopy and liver unit at Kasr El-Aini hospital over the last five years in an attempt at evaluation of the chronological difference in the gastric pattern diagnosed endoscopically over that time period. Results: From the 800 cases of the police hospital 684 (85.5%) of them showed positive Clo test for H pylori infection with a male predominence (86.7%) and that the greatest affection was in the middle age group. Gastric malignancy patients showed the highest prevalance (100%) followed by patients with peptic ulcer (91.6%). For the second part of this study it was conducted on 7262 patients who underwent upper endoscopy at Kasr El-Aini endoscopy unit and showed also a male predominense (61.3%) and the most detected endoscopic finding was gastritis. No significant changes were found in the pattern of gastric pathology through the last 5 years. Conclusion: The prevalence of Helicobacter pylori in Egypt is very high and it affects mainly the middle age group with highest activity and productivity and this could have a further socioeconomic impact when added to the health problems this microorganism could cause.The gastric pattern over the last five years showed no significant changes regarding the different endoscopic gastric lesions.