The Maastricht V/Florence Consensus Report provides an updated guide on the management of *Helicobacter pylori* (H. pylori) infection, addressing key aspects such as indications, diagnosis, treatment, prevention, and the role of H. pylori in gastric microbiota. The report is based on the findings from five workshops involving 43 experts from 24 countries, who used a Delphi process to develop consensus statements. The report emphasizes the increasing resistance to antibiotics and the need for modified therapeutic strategies. It recommends a 'test-and-treat' strategy for uninvestigated dyspepsia, with endoscopy considered for patients with dyspeptic symptoms, especially in low-prevalence areas. H. pylori gastritis is classified as an infectious disease, and eradication therapy is recommended for all infected individuals, regardless of symptoms. The report also highlights the role of H. pylori in various extra-gastric conditions and its association with gastric MALToma. For diagnosis, the 13C-urease breath test (UBT) is recommended as the best non-invasive test, while rapid urease tests (RUT) are suggested for initial screening. Serological tests can be used after validation. Treatment guidelines are provided, emphasizing the importance of susceptibility testing, especially in regions with high clarithromycin resistance. The report concludes by discussing the long-term benefits of H. pylori eradication and the impact of antibiotic resistance on treatment outcomes.The Maastricht V/Florence Consensus Report provides an updated guide on the management of *Helicobacter pylori* (H. pylori) infection, addressing key aspects such as indications, diagnosis, treatment, prevention, and the role of H. pylori in gastric microbiota. The report is based on the findings from five workshops involving 43 experts from 24 countries, who used a Delphi process to develop consensus statements. The report emphasizes the increasing resistance to antibiotics and the need for modified therapeutic strategies. It recommends a 'test-and-treat' strategy for uninvestigated dyspepsia, with endoscopy considered for patients with dyspeptic symptoms, especially in low-prevalence areas. H. pylori gastritis is classified as an infectious disease, and eradication therapy is recommended for all infected individuals, regardless of symptoms. The report also highlights the role of H. pylori in various extra-gastric conditions and its association with gastric MALToma. For diagnosis, the 13C-urease breath test (UBT) is recommended as the best non-invasive test, while rapid urease tests (RUT) are suggested for initial screening. Serological tests can be used after validation. Treatment guidelines are provided, emphasizing the importance of susceptibility testing, especially in regions with high clarithromycin resistance. The report concludes by discussing the long-term benefits of H. pylori eradication and the impact of antibiotic resistance on treatment outcomes.