OBJECTIVE: To investigate current infection with Helicobacter pylori (H. pylori) and related risk factors in children with gastrointestinal symptoms. METHODS: A total of 376 children with upper gastrointestinal symptoms were examined by gastroscopy. Three pieces of gastric mucosa were sampled for rapid urease test and pathohistological examination. Some children received 13C-urea breath test. Children with two or more positive results were diagnosed with H. pylori infection. A questionnaire on living environment, family economic status, parents’ education level and family history of gastrointestinal diseases was completed for all children. RESULTS: The H. pylori infection rate was 44.9% (169/376) in children with upper gastrointestinal symptoms. There was no statistical difference in the infection rate between males and females (P>0.05). The H. pylori infection rates in the 3 to 7-year old, 8 to 12-year old and 13 to 16-year-old children were 39.5% (47/119), 41.0% (55/134), and 54.5% (67/123) respectively, with significant differences between different age groups (χ2 = 6.76, P<0.05). The H. pylori positive rate was significantly higher in children who were in full-time nursery or collective living and dining than in those who were not (53.6% vs 40.6%; P<0.05). The H. pylori positive rate in high-income families was lower than that in middle to low-income families (36.9% vs 48.3%; P<0.05). In addition, the H. pylori positive rate in children with well-educated parents was lower than in those with parents who had not received higher education (39.5% vs 50.8%; P<0.05). The H. pylori infection rate in children with a family history of digestive disease was significantly higher than in those without family history of gastrointestinal diseases (52.9% vs 41.2%; P<0.05). CONCLUSIONS: The infection rate increases with age and is higher in children who are in collective living and dining, come from low income family, have parents who have not received higher education and have a family history of upper gastrointestinal diseases.