Background: The use of endoscopes for visualization of gastric mucosa has improved over times and in taking biopsy for histology. The study sets out to determine the histopathological pattern of gastritis in dyspeptic patients and correlate the histological detection of H. pylori with that of urease breath test (UBT). Method: Prospective study of 118 consecutive patients with chronic dyspepsia who underwent upper gastrointestinal endoscopic examination and UBT using heliprobe. Biopsy of gastric antrum were taken at endoscopy and sent for histopathological analysis. Routine H&E and Giemsa stains were used. Results were recorded and analysed on the basis of sex, age, histology and UBT for H. pylori. Result: There were 118 patients who had endoscopy comprising 58 males and 60 females with male to female ratio of 1:1. Histology revealed varying degrees of chronic gastritis with or without H. pylori, activity, metaplasia, ulceration and dysplasia. Sixty eight (61%) of our patients were positive for H. pylori histologically. Of the first consecutive 66 patients, histology showed 38(57.6%) positive and 28(42.6%) negative; UBT, 46(69.6%) were positive for H. pylori and 20(30.4%) negative. There was a strong correlation between the true positive and true negative patients for the first 66 consecutive cases for both histology and UBT based diagnosis for detecting H. pylori. (Correlation coefficient=0.862, p=0.01). Conclusion: The study showed that histology and UBT are both useful for H. pylori detection. Large multi centre studies should be done to adopt the non-invasive UBT in resource poor economies for the eradication of H. pylori.