Background: Helicobacter pylori are the most common chronic bacterial infection, and a significant etiological factor in acid peptic diseases and gastric cancer. Dyspepsia is a common gastrointestinal disorder, and the most common indication for gastroscopy. Detection of H. pylori during endoscopy has become standard clinical practice. Objective: To detect the different underling OGD causes of dyspeptic symptoms in patients presented to the outpatients clinic of the gastroenterology unit in Al-Ramadi Teaching Hospital, and their microbiological correlate. Methods: From January 2010 to September 2010, eighty patients with various upper gastrointestinal complaints (epigastric pain, heart burn. etc) were evaluated by OGD in the gastro endoscopic unit in AL-ramadi teaching hospital. In all patients after fasting for at least 4 hours an OGD was done using fibroptic (FG29w Pentax) endoscope. Blood samples were collected from patients (5 ml of venous blood) serum was separated and stored frozen for further processing.Preliminary screening dipstick assay was performed to detect the presence or absence of H.pylori serologically, after that confirmatory anti H.pylori lgG was done by enzyme linked immunosorbent assay with DRG (Germany) kit. The results were interpreted as positive if the optical density is (1.192 Du / ml) and above, and it considered negative if optical density (0.357 Du/ ml) and below, and all the recording between (1.192 0.357) were reflected the grey zone result (equivocal results), were regarded as negative too. Results: In the present study H. pylori infection was detected in (44%6) of patients by anti H.pylori antibody (IgG), and (56%) by dipstick assay. In the present study there was a great correlation between H. pylori infection with CA stomach (20) (100%), P.U. disease (71%), gastritis (63%) (%erosions (57%) respectively, while a correlation was negligible with GERD and gastric polyps (21). Conclusion: The invasiveness and cost of endoscopy and the difficulty to perform urea breath test and stool antigen to all patients makes serological tests as a much convenient alternative so it was selected in our study. H. pylori role in dyspepsia seems to be an important risk factor that should be considered, discovered and eradicated However, further studies may be needed in larger number of patients to establish ELISA test as a conclusive procedure.