Objective H. pylori infection in children has a high prevalence worldwide. The disease can cause progressive gastric mucosal inflammation, as verified in animal models. However, data from large-scale clinical studies are limited. Methods We examined 1,634 Chinese children with upper gastrointestinal discomfort using endoscopy. The clinical and pathological data of the patients were analyzed. Results A total of 524 (32.1%) patients were infected with H. pylori , and the prevalence of H. pylori infection increased with age. The H. pylori -infected patients exhibited a significantly higher prevalence of active inflammation (26.9% vs. 4.1%), lymphoid follicle formation (18.5% vs. 4.6%) and marked lymphocyte infiltration (19.7% vs. 5.6%). The H. pylori -infected patients also exhibited a significantly higher prevalence of moderate to marked chronic superficial gastritis (41.9% vs. 9.2%) and moderate chronic atrophic gastritis (21.7% vs. 2.6%) than the uninfected patients (p
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