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Background and Aims: Helicobacter pylori infection rates are reported to be high in people over the age of 40 years, but are decreasing in younger age groups. A negative correlation has been reported between H. pylori infection and reflux esophagitis (RE). Methods: The subjects were 418 patients who underwent esophagogastroduodenoscopy and measurement of serum immunoglobulin G H. pylori antibodies examined as part of their routine health checks. Their mean age was 39.2 ± 8.3 years (range 22–58). We analyzed the RE findings (Los Angeles classification: A, B, C, D). Results: The total H. pylori infection rate was 33.7% (141/418). By age group, infection rates were 15.7% in the 20–29 years group, 28.0% in the 30–39 group, 34.3% in the 40–49 group and 69.1% in the 50–59 group. The proportion of H. pylori-negative subjects with RE was 23.5% (20–29, 22.9%; 30–39, 31.7%; 40–49, 32.4%; 50–59, 41.7%), significantly higher than that (12.1%) in H. pylori-positive subjects (20–29, 0%; 30–39, 16.7%; 40–49, 12.2%; 50–59, 10.5%). The severity of RE increased with advancing age in H. pylori-positive subjects, but not in H. pylori-negative subjects. Conclusion: In this study, higher rates of RE were seen in H. pylori-negative subjects. It may be, however, that the presence of H. pylori infection influences the progression of RE. [ABSTRACT FROM AUTHOR]