The Maastricht IV/Florence Consensus Report on the management of Helicobacter pylori infection provides updated guidelines based on the latest evidence and expert consensus. The report addresses the clinical role of H. pylori in various conditions, including dyspepsia, gastro-oesophageal reflux disease (GORD), peptic ulcer disease, and gastric cancer prevention. It also discusses the use of H. pylori eradication in patients on NSAIDs or aspirin, and its impact on acid secretion and gastric mucosa. The report emphasizes the importance of testing and treating H. pylori in populations with high prevalence, particularly in young patients with dyspepsia, and highlights the benefits of eradication in reducing symptoms and preventing complications. It also notes that H. pylori eradication is not recommended in patients with a high risk of gastric cancer, such as those with alarm symptoms or signs. The report also discusses the use of non-invasive tests like the urea breath test (UBT) and stool antigen test for diagnosis, and the role of PPIs in managing H. pylori-related conditions. The report recommends that H. pylori eradication should be considered in patients with peptic ulcer disease, and that the choice of treatment should be based on local resistance patterns and patient factors. The report also addresses the use of H. pylori in extragastric diseases, including its association with iron-deficiency anaemia, neurological conditions, and certain cancers. The report concludes that H. pylori eradication is a key component of managing H. pylori-related diseases and that the choice of treatment should be based on the latest evidence and local guidelines.The Maastricht IV/Florence Consensus Report on the management of Helicobacter pylori infection provides updated guidelines based on the latest evidence and expert consensus. The report addresses the clinical role of H. pylori in various conditions, including dyspepsia, gastro-oesophageal reflux disease (GORD), peptic ulcer disease, and gastric cancer prevention. It also discusses the use of H. pylori eradication in patients on NSAIDs or aspirin, and its impact on acid secretion and gastric mucosa. The report emphasizes the importance of testing and treating H. pylori in populations with high prevalence, particularly in young patients with dyspepsia, and highlights the benefits of eradication in reducing symptoms and preventing complications. It also notes that H. pylori eradication is not recommended in patients with a high risk of gastric cancer, such as those with alarm symptoms or signs. The report also discusses the use of non-invasive tests like the urea breath test (UBT) and stool antigen test for diagnosis, and the role of PPIs in managing H. pylori-related conditions. The report recommends that H. pylori eradication should be considered in patients with peptic ulcer disease, and that the choice of treatment should be based on local resistance patterns and patient factors. The report also addresses the use of H. pylori in extragastric diseases, including its association with iron-deficiency anaemia, neurological conditions, and certain cancers. The report concludes that H. pylori eradication is a key component of managing H. pylori-related diseases and that the choice of treatment should be based on the latest evidence and local guidelines.