Background and AimNodular gastritis is caused by Helicobacter pylori infection and is associated with the development of diffuse‐type gastric cancer. This study examined the clinical characteristics of patients with nodular gastritis, including cancer incidence before and after H. pylori eradication.MethodsThis was a retrospective study of patients who underwent upper endoscopy and were positive for H. pylori infection. We examined the clinical findings and follow‐up data after H. pylori eradication in patients with and without nodular gastritis.ResultsOf the 674 patients with H. pylori infections, nodular gastritis was observed in 114 (17%). It was more prevalent in women (69%) and young adults. Among patients with nodular gastritis, six (5%) had gastric cancer, all of which were of the diffuse type. Among the 19 (4%) patients with gastric cancer and no nodular gastritis, 16 had intestinal‐type cancer. White spot aggregates in the corpus, a specific finding in patients with nodular gastritis, were more frequently observed in patients with gastric cancer than in those without (83% vs 26%, P = 0.0025). Of 82 patients with nodular gastritis who had H. pylori eradicated successfully, none developed gastric cancer over a 3‐year follow‐up period, while 7 (3%) of 220 patients without nodular gastritis developed gastric cancer after H. pylori eradication.ConclusionsIn patients with nodular gastritis, white spot aggregates in the corpus may indicate a higher risk of developing diffuse‐type gastric cancer. Nodular gastritis may be an indication for eradication therapy to reduce the risk of cancer development after H. pylori eradication.