Aims To asess the accuracy of high resolution upper endoscopy (Olympus) in predicting the presence of H. pylori gastritis in routine upper endoscopy examinations Methods All patients undergoing an upper endoscopy in a single endoscopy center by a single operator over a 4 week period (n=225) were asessed with the high resolution Olympus upper endoscope for the presence of H. pylori. Endoscopic stigmata (mosaic, erosive, atrophic and minor gastrits) were compared with the combination of rapid urease test and histology for the diagnostic accuracy in detecting H pylori. Results see table Conclusion A normal looking mucosa of the stomach during high resolution upper endoscopy excludes H pylori. Routine use of these instruments will markedly reduce the routine need for biopsies eliminating a significant cost to the patient and endoscopy center