The route of transmission of H. pylori is still not well established and is mostly thought to be through oral infection, gastrointestinal transmission and fecal-oral transmission routes. H. pylori is a microaerobic bacterium that is highly adapted to the stomach, which is rich in digestive enzymes and acidic environment, and colonizes the gastric mucosal surface and between the mucosal layers. The susceptibility of H. pylori to drug-resistant mutations is the main reason for the failure of eradication therapy, which requires the targeted selection of sensitive drugs for the treatment of H. pylori infection based on the results of in vitro drug sensitivity tests or antibiotic resistance information of H. pylori in a particular region. Because of the poor efficacy of a single drug against H. pylori, a “quadruple therapy” is generally recommended to improve eradication. The common antibiotics used to treat H. pylori infection are nitroimidazoles (metronidazole), macrolides (clarithromycin), B-lactams (amoxicillin) and tetracycline, etc. The specific treatment plan is bismuth plus two antibiotics, and for ulcer patients, proton pump inhibitors plus one antibiotic or H2 receptor antagonists plus two antibiotics can be applied for two consecutive weeks. Due to the widespread use of antibiotic regimens for H. pylori, the problem of its resistance has become increasingly serious, thus the issues of drug sensitivity testing, replacement therapy and prevention deserve attention and research. H. pylori is the main causative factor of gastritis and peptic ulcer, and is closely related to the development of gastric MALT lymphoma and gastric cancer. Patients with confirmed infection need regular and standardized medication.