<b><i>Background:</i></b> <i>Helicobacter pylori</i> (<i>H</i>. <i>pylori</i>) infection is the most prevalent type of bacterial infection. Current guidelines from different regions of the world neglect specific African conditions and requirements. The African Helicobacter and Microbiota Study Group (AHMSG), founded in 2022, aimed to create an Africa-specific consensus report reflecting Africa-specific issues. <b><i>Summary:</i></b> Eighteen experts from nine African countries and two European delegates supported by nine African collaborators from eight other countries prepared statements on the most important African issues in four working groups: (1) epidemiology, (2) diagnosis, (3) indications and prevention, and (4) treatment. Limited resources, restricted access to medical systems, and underdeveloped diagnostic facilities differ from those of other regions. The results of the individual working groups were presented for the final consensus voting, which included all board members. <b><i>Key Messages:</i></b> There is a need for further studies on <i>H. pylori</i> prevalence in Africa, with diagnosis hinged on specific African situation. Treatment of <i>H. pylori</i> in the African setting should be based on accessibility and reimbursement, while indication and prevention should be defined in specific African countries.