Autoimmune atrophic gastritis (AAG) is a chronic condition characterized by the atrophy of the oxytic mucosa due to anti-parietal cell antibodies. This review provides recent evidence on the epidemiology, pathogenesis, diagnosis, clinical presentation, risk of malignancies, and management of AAG. AAG is relatively rare, with a prevalence of 0.3% to 2.7% in the general population. It is more common in women and older individuals, and is associated with autoimmune disorders such as type 1 diabetes and autoimmune thyroiditis. Diagnosis is based on serological markers and histological examination of gastric biopsies. AAG can lead to malabsorption, vitamin deficiencies, anemia, neurological disorders, and an increased risk of gastric malignancies, including neuroendocrine tumors and gastric cancer. Management focuses on correcting vitamin and iron deficiencies and preventing malignancies through endoscopic surveillance. The review highlights the importance of early diagnosis and appropriate follow-up to improve outcomes and guide future research. AAG is often underdiagnosed, especially in asymptomatic patients, and requires careful evaluation to ensure timely intervention. The relationship between AAG and Helicobacter pylori infection remains unclear, and further studies are needed to clarify the role of H. pylori in the development and progression of AAG. New treatments aimed at reducing gastric inflammation and preventing atrophy are also needed. Overall, AAG is a complex condition that requires a multidisciplinary approach for effective management.Autoimmune atrophic gastritis (AAG) is a chronic condition characterized by the atrophy of the oxytic mucosa due to anti-parietal cell antibodies. This review provides recent evidence on the epidemiology, pathogenesis, diagnosis, clinical presentation, risk of malignancies, and management of AAG. AAG is relatively rare, with a prevalence of 0.3% to 2.7% in the general population. It is more common in women and older individuals, and is associated with autoimmune disorders such as type 1 diabetes and autoimmune thyroiditis. Diagnosis is based on serological markers and histological examination of gastric biopsies. AAG can lead to malabsorption, vitamin deficiencies, anemia, neurological disorders, and an increased risk of gastric malignancies, including neuroendocrine tumors and gastric cancer. Management focuses on correcting vitamin and iron deficiencies and preventing malignancies through endoscopic surveillance. The review highlights the importance of early diagnosis and appropriate follow-up to improve outcomes and guide future research. AAG is often underdiagnosed, especially in asymptomatic patients, and requires careful evaluation to ensure timely intervention. The relationship between AAG and Helicobacter pylori infection remains unclear, and further studies are needed to clarify the role of H. pylori in the development and progression of AAG. New treatments aimed at reducing gastric inflammation and preventing atrophy are also needed. Overall, AAG is a complex condition that requires a multidisciplinary approach for effective management.