Autoimmune atrophic gastritis (AAG) is a chronic condition characterized by the atrophy of the oxyntic mucosa due to anti-parietal cell antibodies. This review provides an up-to-date overview of AAG, covering recent evidence on its epidemiology, pathogenesis, diagnosis, clinical presentation, risk of malignancies, and management. The prevalence of AAG is estimated between 0.3% and 2.7% in the general population, with variations among ethnic groups, geographic regions, and genders. AAG is often asymptomatic but can lead to malabsorption, vitamin deficiencies, and an increased risk of gastric malignancies, including type 1 neuroendocrine tumors (NETs) and gastric cancer. Diagnosis is based on serologic markers and histological examination of gastric biopsies. Management aims to correct iron and vitamin deficiencies and prevent malignancies through endoscopic surveillance. The review highlights the need for early diagnosis and appropriate treatment to improve patient outcomes and shape future research directions.Autoimmune atrophic gastritis (AAG) is a chronic condition characterized by the atrophy of the oxyntic mucosa due to anti-parietal cell antibodies. This review provides an up-to-date overview of AAG, covering recent evidence on its epidemiology, pathogenesis, diagnosis, clinical presentation, risk of malignancies, and management. The prevalence of AAG is estimated between 0.3% and 2.7% in the general population, with variations among ethnic groups, geographic regions, and genders. AAG is often asymptomatic but can lead to malabsorption, vitamin deficiencies, and an increased risk of gastric malignancies, including type 1 neuroendocrine tumors (NETs) and gastric cancer. Diagnosis is based on serologic markers and histological examination of gastric biopsies. Management aims to correct iron and vitamin deficiencies and prevent malignancies through endoscopic surveillance. The review highlights the need for early diagnosis and appropriate treatment to improve patient outcomes and shape future research directions.