Abstract: Objective To investigate the association of the pathogenesis of reflux esophagitism (RE) with Helicobacter pylori (H. pylori) infection. Methods The prevalences of H. pylori among the patients with RE, normal control subjects, patients with chronic gastritis and patients with duodenal ulcer, as well as the prevalence of H. pylori infection in RE patients of each grade, were compared. Forty patients with endoscopically verified RE grades B or C, along with 20 patients with and another 20 without H. pylori infection were enrolled to receive a 4-week course of rabeprazole treatment, and the subsequent healing rates and symptom relief were compared. Results The prevalences of H. pylori in groups RE, control, chronic gastritis and duodenal ulcer were 30.4%, 28.8%, 59.0% and 91.5% respectively. The rate of H. pylori infection in patients with RE was significantly lower than that in those with chronic gastritis and duodenal ulcer, but was comparable with that in the control subjects. H. pylori infection varied little among RE patients of different grades. In RE patients positive or negative for H. pylori, the healing rates and relief of the symptoms were not different after the treatment. Conclusion H. pylori infection might not be responsible for the susceptibility to RE.