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Maria-Raquel Huerta-Franco,1,2 Julie W Banderas,1 Jenifer E Allsworth1 1Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA; 2Department of Applied Sciences to Work, Division of Health Sciences, Campus Leon, University of Guanajuato, Leon, Mexico Background: In the US, neither the prevalence nor the gastrointestinal (GI) diagnosis/symptoms associated with Helicobacter pylori (HP) have been examined in different racial/ethnic groups.Aim: To determine the racial/ethnic differences in HP infection associated with GI diagnoses/symptoms using the Cerner Health Facts® database.Methods: This cross-sectional study collected data during the period of 2000–2015 from the following ethnic/racial groups: 8,236,317 white, 2,085,389 black, 426,622 Hispanic, 293,156 Asian Pacific/Islander (APIs), and 89,179 Native American/Alaskan Native (NA/AN) patients aged 21–65 years old; the data were then analyzed. The primary dependent variable was a diagnosis of HP (ICD-9-Clinical Modification/ICD-10 classification). SAS version 9.4 was used for the statistical analysis. The statistical analysis was performed on 11,130,663 patients with GI symptoms, and of these, 152,086 patients were positive for the infection.Results: Hispanics and NA/ANs had the highest prevalence of HP associated with upper GI symptoms/diagnosis. Nevertheless, blacks and APIs presented the highest relative risk (RR) of HP associated with dyspepsia (RR [95% CI] =11.2 [10.7–11.9] and 14.2 [12.8–15.6]), peptic ulcer (RR =13.8 [13.3–14.5] and 10.7 [9.3–12.3]), and atrophic gastritis (RR =9 [8.5–9.6] and 7.4 [6.4–8.5]), respectively. In all racial/ethnic groups, HP was also associated with inflammatory bowel diseases, liver diseases, and celiac diseases.Conclusion: Black and API populations had the highest risk of HP associated with upper GI symptoms/diagnosis. Black patients also had the highest risk for HP associated with GI cancer. Keywords: race/ethnicity, dyspepsia, peptic ulcer, gastrointestinal cancer, Helicobacter pylori