The research study was conducted in Kasr EL-Aini Hospital. The study was conducted on one hundred patients with chronic renal failure and divided into two groups,50 patients on conservative treatment (groupI) and 50 patients on dialysis (group II).Patients of both groups were subjected to complete history taking and clinical examination, laboratory investigations, Abdominal Ultrasonography, Upper Gastrointestinal endoscopy and antral Biopsies for detection of H. pylori infection and proved that;Prevalence of gastrointestinal symptoms showed no statistical significant changes between the two groups. Endoscopic examination to patients with chronic renal failure on conservative treatment revealed that gastric mucosa were normal in about half of the patients compared to those on dialysis. On the contrary, abnormal gastric mucosa was more (92%) in those on dialysis.Gastric ulcers were found in 55% in patients on conservative management and 14% in patients on dialysis. Also, duodenal ulcers were found in 55% in pateits on conservative management and in 39% in patients on dialysis. There was statistiacl significance between these parameters. H. pylori was found in only 22% of patients with chronic renal failure on conservative management and 72% of pathients with chronic renal failure on dialysis. Finally, we came to the conclusion that there is difference between gastroduodenal affection between patients with chronic renal failure on conservative mangement and those on dialysis. Moreover, H. pylori infection may play a considerable role in the pathogenesis of gastroduodenal affection in chronic renal failure patients on hemodialysis group.