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Objective This study aimed to compare the diagnostic value and image quality of high-definition magnifying white light endoscopy ( M- WLE) and high-definition magnifying endoscopy with i-scan ( M-i-scan) for Helicobacter pylori ( H. pylori) infection. Methods Patients complaining of dyspepsia who underwent esophagogastroduodenoscopy at the Endoscopy Unit of Qilu Hospital ( Jinan, Shandong Province, China) from January to March, 2011 were prospectively recruited. The greater curvature of the stomach was carefully observed using both M- WLE and M-i-scan. The gastric mucosal classification and image quality scores were recorded. The relationship between gastric mucosal classification and final diagnosis of H. pylori infection was determined. Results A total of 84 patients were recruited in this study. The accuracy and specificity of the combination of types 2-3 patterns predicting H. pylori infection were significantly higher for M-i-scan than those for M- WLE (accuracy: 94.0% vs 84.5%, P = 0.046; and specificity: 93.5% vs 80.6%, P = 0.032), while the sensitivity of the two modes was the same. The M-i-scan provided a better image quality for H. pylori infection than M- WLE ( P < 0.001). Conclusion The M-i-scan may be superior to M- WLE for the prediction of H. pylori infection, but its diagnostic sensitivity needs to be improved. [ABSTRACT FROM AUTHOR]