Helicobacter pylori causes chronic gastritis and peptic ulcer disease and is epidemiologically associated with the subsequent development of gastric malignancies. Knowledge regarding H. pylori is of particular relevance to pediatricians since acquisition of the infection occurs mainly during the childhood years and may be associated with the development of more severe disease manifestations such as gastric malignancies. Because only a minority of infected individuals will ever develop the sequelae of peptic ulcer disease or gastric cancer, the identification of bacteria factors that play a role in disease pathophysiology is a major focus of current research. This review highlights recent advances in our knowledge of disease pathogenesis, with particular emphasis on bacterial virulence. In addition, the recent literature addressing epidemiology, transmission, clinical features, treatment, and prevention of H. pylori infection is reviewed.