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Background and study aims: Portal hypertensive gastropathy (PHG) is a complication of portal hypertension in patients with liver cirrhosis, and it is considered one of the causes of upper gastrointestinal bleeding. Helicobacter pylori (H. Pylori) is one of the most common pathogenic organism worldwide because it infects 50% of the population all over the world. The role of H. Pylori infection in the development of PHG and its severity is controversial. The aim of this study is to determine the frequency of H. pylori infection in cirrhotic patients with PHG, and to find out the possible association of H.pylori infection with PHG severity. Method: This study was carried out on 90 patient with cirrhotic liver. Patients were divided into two groups according to the presence or absence of PHG diagnosed by upper endoscopy. Child's Pugh score, MELD, uMELD and detection of H.Pylori by histopathological examination were done for all patients. Results: The studied patients 47 were males and 43 were females their mean age was 51.96 ± 7.02 years (ranging between 38-66 years). H.Pylori infection was significantly more frequent in patients with PHG than patients without PHG (P= 0.001). H.Pylori infection was significantly more frequent in patients with severe PHG than those with mild PHG (P=0.012). By multi-variant analysis, splenomegaly, presence of esophageal varices, gastric varices and H. Pylori infection were independent predictors for PHG presence. Conclusion: H. Pylori infection could be an independent predictor for PHG development and associated with its severity.