AbstractThis chapter discusses the relationship between Helicobacter pylori infection and associated diseases (chronic gastritis, peptic ulcer disease and gastric adenocarcinoma) and describes the route of H. pylori transmission. The geographical distribution and changing trends of the prevalence of H. pylori infection, the changes in the environment and human behaviour that influence the prevalence of H. pylori infection, and the decreasing prevalence of infection-induced ulcers in western countries are reviewed.