Background Helicobacter pylori is a gram-negative bacterium that infects half of the populations worldwide (1). In addition, it can cause gastric and duodenal ulcer and predispose to individuals gastric adenocarcinoma (2). Further, H. pylori infection is persistent while asymptomatic in most individuals. However, whenever the microorganism is diagnosed, it should be eradicated with the administration of antibiotics and the proton pump inhibitor (3). The determinants of the successful eradication of this microorganism include drug efficacy, bacterial resistance, and the patient's compliance. However, antibiotic resistance is considered as the most common cause of eradication failure and varies in different countries and within different regions of the same country (3), challenging H. pylori eradication and H. pylori-related complication treatment (3). Different variables may play an important role in the treatment failure of H. pylori, including patient characteristics, underlying disease presence, and environmental factors. The recommended course of the treatment includes the combination of amoxicillin plus clarithromycin with a proton pump inhibitor in the majority of international guidelines for the eradication of H. pylori (4, 5). The bismuth-containing quadruple or levofloxacin-based regimen (LBR) is advised for H. pylori eradication if the clarithromycin resistance rate is more than 20%. According to previous research, the clarithromycin resistance rate is 20% in Iraq (6). Nonetheless, no clinical trial study, to the best of our knowledge, has so far investigated the eradication success rates of bismuthcontaining quadruple or LBR in this country. Objectives The aim of our project was to evaluate the effectiveness of levofloxacin versus bismuth-based courses for the eradication of H. pylori.