This article reviews the current situation regarding research towards an effective human vaccine against Helicobacter pylori, with particular emphasis on developments in the new millennium. The mechanism(s) by which immunisation of mice can affect helicobacter colonisation of mice remains a mystery, but may be related to immune mediated environmental changes. In particular, it is proposed that severe gastritis and T-cell mediated changes in mucin production can significantly impact upon H. pylori colonisation. Despite the potential influence of environmental factors, significant progress towards a truly effective vaccine may depend upon the induction of specific immune targeting of this pathogen. This would probably be best achieved by the generation of an appropriate antibody response, something which has not yet been accomplished. An overview of previous and current H. pylori vaccine clinical trials is also presented.