Helicobacter pylori (H. pylori) is a highly prevalent pathogen considered as an aetiological factor for gastric ulcers and gastric cancer. Most children colonized by H. pylori are asymptomatic and remain untreated. In symptomatic patients, the antibiotic treatment is not 100% effective because of the resistance to antibiotics and the imperfect patient compliance. Mono-therapy or dual-therapy have a very low efficacy. Dual therapies with bismuth plus one antibiotic or two antibiotics for two weeks are as effective as either bismuth-based or proton pump inhibitor-based triple therapies. Triple therapies were less effective than in adults, and proton pump inhibitor-based triple therapies have a similar efficacy irrespective of the duration. Recently, a new sequential treatment proved to be more efficacious than standard therapies. Recent data suggest that probiotics may maintain lower levels of H. pylori in the stomach, and in combination with antibiotics, probiotics may decrease adverse effects. Probiotics might constitute a low-cost, large-scale alternative solution applicable for populations at-risk for H. pylori colonization.