Since the discovery of Helicobacter pylori (Hp) in 1983, the role of Hp in the pathogenesis of chronic active gastritis, chronic atrophic gastritis and peptic ulcer has attracted great attention from scholars at home and abroad, and it is believed that Hp is a class I (definite) carcinogen for the development of gastric adenocarcinoma. Epidemiological data suggest that long-term Hp infection can lead to atrophy of the gastric mucosa, intestinal epithelial chemosis and heterogeneous hyperplasia, and eventually to gastric cancer. The methods for diagnosing Hp infection are broadly divided into two categories: invasive tests using gastroscopy to remove gastric mucosal tissues by forceps and non-invasive tests that do not require gastroscopy, the former including rapid urease test (RUT), pathological histological examination, Hp culture, polymerase chain reaction (PCR) technique and intragastric indicator spray staining. The latter includes serum Hp antibody assay, isotope-labeled urea breath test (UBT), and fecal Hp antigen assay. Hp eradication can control ulcer symptoms, shorten treatment time and prevent recurrence. The triple therapy of PPI plus two antibiotics is now recommended in China and abroad. The ideal Hp eradication protocol should meet the criteria of effectiveness, simplicity, economy and safety. At present, the ideal Hp treatment plan should include: (1) Hp eradication rate >90%; (2) minimal side effects; (3) good patient compliance; (4) fast ulcer healing; (5) no drug resistance; (6) simple treatment and short course of treatment; and (7) cheap price. The choice of antibiotics varies from person to person because each person’s situation is different, especially those who used antibacterial drugs frequently in the past are prone to drug resistance, and some patients may be allergic to certain drugs. It is strongly recommended that people with Hp infection should not be treated casually! In clinical work, we often encounter the use of single antibiotics such as amoxicillin or clarithromycin or gentamicin to treat chronic gastritis, in fact, most chronic gastritis is chemical inflammation does not require antibiotics and is ineffective when used. On the contrary, if it is Hp infection irregular application of antibiotics is very likely to lead to bacterial resistance, bringing difficulties to the eradication treatment in the future.