20 children with suspected Helicobacter pylori (H. pylori) infection are presented. The mean age of the children was 9.4 years (range 4-13 years). The mean H. pylori IgG and IgA antibodies were 677 units and 760.7 units respectively. Antral biopsy cultures were positive in five children. Histopathology of the gastric antral and duodenal biopsies showed H. pylori gastritis in 11 children, duodenitis and gastritis in five, normal histology in three and one child had normal histology with H. pylori like organism on the surface of the antral mucosa. From this study, we conclude that serology is a good diagnostic test for H. pylori infection in Saudi Arabia.