The role of Helicobacter pylori as the main reason for the most common gastric diseases has been confirmed during 25 years of research. Estonian guidelines for the diagnosis and treatment of the diseases associated with Helicobacter pylori infection were approved in 1999 and 2004. According to the consensus report of Maastricht III, minor revision of guidelines is needed. Atrophic gastritis, first degree relatives of patients with gastric cancer and patients who wish to be treated should be included in the group of diseases requiring treatment for Helicobacter pylori infection. Stool Helicobacter pylori antigen test should be included in the list of noninvasive diagnostic methods. The first line scheme of Helicobacter pylori eradication should be complemented with bismuth drugs and duration of treatment after unsuccessful eradication has to be longer than one week.