Treatment is required for H. pylori patients over 60 years of age. The main pathogenic substances of H. pylori are invasive factors and toxins, which can invade the gastric mucosa of human body through flagella and bacterial hairs and secretion of urease. At the same time, H. pylori can produce vacuole toxin A and cytotoxin-associated protein A. Vacuole toxin A can lead to vacuolated lesions in gastric mucosal epithelial cells. Cytotoxin-associated protein A can activate the expression of cellular oncogenes and inhibit the expression of oncogenes, inducing malignant transformation and increasing the risk of gastric cancer. Therefore, for people over 60 years old with H. pylori, timely treatment is still needed. It can avoid the damage of gastric mucosa caused by H. pylori invasion leading to chronic gastritis, gastric ulcer and duodenal ulcer, and at the same time, active treatment can also slow down the incidence of gastric cancer. After the infection of H. pylori, you can take bismuth or proton pump inhibitor as the basis, plus amoxicillin, clarithromycin or metronidazole and other two kinds of antibiotics to combine the treatment under the guidance of the doctor. However, the choice of specific drugs also needs to be dynamically adjusted according to the individual’s drug resistance and the presence of allergies.