Background: Helicobacter pylori (H. pylori), a highly prevalent gastrointestinal organism, infects more than 50% of the global population. It is the most common risk factor for peptic ulcer disease, cancer stomach and gastric lymphoma. Eradication therapy regimens for H. pylori are highly effective. However, bacterial resistance to antibiotics and patients non￾adherence to the treatment regimens significantly increased the recurrence rates of H. pylori infection in the last few decades. Patients and Methods: We evaluated and followed up 157 patients for one year after confirmed successful eradication of H. pylori infection. We investigated the patients at 3, 6, 9 and 12 months for recurrence of H. pylori infection using urea breath and stool antigen tests. Study Aim: To assess the prevalence and possible risk factors of H. pylori recurrence in Egyptian patients after eradication therapy. Results and Conclusion: We found a one-year recurrence rate of 19% after successful eradication therapy of H. pylori. The education level of the patients and alcohol consumption were the most significant predictors of H. pylori recurrence. The one-year recurrence rate in our study is high but comparable to those reported in the developing countries most probably due to high rates of re-infection and non-adherence to the preventive measures