Background: H. pylori eradication usually involves treatment with three or four drugs for at least 7 days. Possible advantages of short treatment regimens are better patient compliance and tolerability, and less adverse effects. Recently two reports have shown a cure rate of > 90% using a 4‐day quadruple therapy.Aim:To confirm these data and to evaluate the efficacy and tolerability of 4‐day quadruple therapy in a single centre.Methods:Thirty‐eight consecutive patients with non‐ulcer dyspepsia or peptic ulcer disease, and proven H. pylori infection, received 4 days of quadruple therapy (bismuth, tetracycline, metronidazole, lansoprazole). At least 6 weeks after treatment, endoscopy was repeated with six biopsies of antrum and corpus for histology and culture.Results:The intention‐to‐treat cure rate was 34/38 (89.5%, 95% CI: 79.7–99.2%). In the per protocol analysis the cure rate was 34/37 (91.9%, 95% CI: 83.1–100%). Primary metronidazole resistance was observed in two patients; both were cured. Metronidazole resistance induction was observed in one patient in whom therapy failed. The treatment was generally well tolerated.Conclusion:Routine use of 4‐day quadruple anti‐H. pylori treatment is effective and well tolerated.