Background and aim: Variation in the clinical outcome of Helicobacter pylori (H. pylori) induced pathology is multifactorial, involving a complex interplay between the host immune responses and pathogen virulence factors. Patients and methods: This study included 95 H. pylori infected patients who underwent endoscopy. They selected if culture and/or histopathological examination and rapid urease test were positive. All patients were examined for presence of cag E and LL-37. Results: Endoscopic findings in the patients were variable. The most frequent findings was gastritis 45.3% (43/95), followed by duodenitis; 36.8% (35/95), duodenal ulcer; 14.7% (14/95), esophagitis; 11.6% (11/95) and the least frequent one was gastric ulcer; 4.2% (4/95). Interestingly, cag E was positive in 27.4% of patients (26/95). As regards LL-37, its mean ± SD was 123.25 ± 20.26 ng/mL. Classifying studied patients into peptic ulcer and non peptic ulcer groups, cag E was positive in patients with peptic ulcer more than those who were non peptic (88.9 % versus 13%) (OR=0.019; CI 0.004-0.094), P<0.001. The difference between two groups as regard LL-37 was statistically significant (CI 44.87-51.98), P<0.001. Conclusion: This study concluded that there was a strong association of cag E and LL-37 serum level with H. pylori-induced peptic ulceration in Egyptian patients.