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The aim of this study was to investigate the prevalence of Helicobacter pylori (H. pylori) infection and intestinal metaplasia in adult dispeptic patients. (attending an endoscopy clinic at our training and referral hospital in Turkey).A total of 3301 consecutive dyspeptic patients, with a mean age +/- SD of 45.97 +/- 15.15 years, had two antral and two corporal biopsies, during routine upper gastrointestinal endoscopy. Patients were divided into three groups according to age; 18-40 years old, 41-60 years old and over 60 years old. Histological specimens were examined and graded according to the Updated Sydney System for H. Pylori infection and intestinal metaplasia.H. pylori was established in 2353 patients (71.3%). Intestinal metaplasia was found in 586 patients (17.8%). Of these patients, 86% (n:504) had complete and 14% (n:82) had incomplete intestinal metaplasia. Frequency and severity of H. pylori infection decreased significiantly in the older group (p0.001). Patients with intestinal metaplasia were older (53.6 +/- 14.9 years) than patients without intestinal metaplasia (44.3 +/- 14.7 years) (p0.001). There was no statistically significant relationship between intestinal metaplasia and H. pylori presence (p0.05). Intestinal metaplasia was more prevalant in patients with mild infection (21.9%) than in patients without Helicobacter pylori infection (16.3%) or with moderate (16.2%) or severe infection (14.6%) (p0.01)H. pylori infection and density decreases, while the prevalence of intestinal metaplasia and incomplete intestinal metaplasia percentage increases in older dyspeptic patients. Mild H. Pylori colonisation could be a sign of intestinal metaplasia, especially in the elderly.