H. pylori is a spiral, gram-negative, microaerobic bacterium. Almost half of the population is infected for life, and the site of infection is mainly in the stomach and duodenal bulb. Most patients with Hp infection are insidious, without systemic symptoms of bacterial infection and often without acute symptoms of gastritis, and patients often present clinically with chronic gastritis and peptic ulcer. H. pylori (HP) infection is closely related to gastritis and gastric ulcer in children. The prevalence of HP infection in children is significantly higher in developing countries than in developed countries, and according to relevant data, the prevalence of HP infection in Chinese children ranges from 48.98% to 77.78% and increases with age. Therefore, the diagnosis and treatment of H. pylori infection in children is of great importance. The source and route of transmission of H. pylori infection are not yet fully understood. However, most scholars believe that humans are the main source of infection, followed by animals. The transmission route is mainly through the oral-oral or fecal-oral route. The prevalence of HP infection is much higher in countries and regions where chopsticks are used to share meals and mothers are used to chew food before feeding their children. Clinical presentation Most children with HP infection are “asymptomatic carriers”. Chronic abdominal pain is the most common and prominent manifestation of HP infection in children. Some of them present with chronic and recurrent abdominal pain, vomiting, vomiting blood, blood in stool, belching, bloating, wasting, headache, irritability and bad breath. Treatment There is no consensus on the need for eradication of HP in children, as it is believed that HP infection in children is self-limiting and most children with HP infection are clinically asymptomatic. In addition, the recurrence rate in young infants is high despite eradication treatment, and the improvement of symptoms after eradication of HP is not obvious if there are no combined ulcers. Therefore, most scholars in pediatrics advocate that anti-HP therapy is not needed for children with HP infection who are effectively treated with conventional therapy and are asymptomatic. Currently, triple or quadruple regimens are generally used, with low doses and short courses of treatment being preferred. Commonly used programs are: (1) PPI + hydroxybenzyl penicillin + metronidazole (or tinidazole) for 1 week; (2) PPI + hydroxybenzyl penicillin + clarithromycin for 1 week; (3) PPI + clarithromycin + metronidazole for 1 week; (4) bismuth + clarithromycin + metronidazole for 2 weeks; (5) bismuth + clarithromycin + furazolidone for 2 weeks; (6) bismuth + hydroxybenzyl penicillin + metronidazole for 2 weeks.