Objective: The aim of this research is to detect the role of eradication of Helicobacter pylori in pregnant women with hyperemesis gravidarum (HG) using modified, high dose, non-teratogenic dual therapy. Study design: Randomized controlled trial. Patients and methods: The study included 156 pregnant women suffering from HG with positive fecal antigen test for Helicobacter pylori. Participants were divided randomly into two groups: group A that received the traditional management for HG (diet instructions, intravenous fluids, electrolyte replacement, antiemetics and vitamins supplementation), and group B that received the previous management for HG plus adding eradication dual therapy for Helicobacter pylori in form of Lansoprazole 30 mg TID + Amoxicillin 1 g TID for 2 weeks and the clinical response to both lines of management was evaluated in both groups two weeks after the start of management. Results: There is a statistically significant difference between both groups as regard clinical response to the used regimen with more clinical improvement in group B. Conclusion: There is an association between Helicobacter pylori infection and hyperemesis gravidarum, allowing us to conclude that Helicobacter pylori should be considered as one of the risk factors of HG. Screening for Helicobacter pylori should be added to the investigations of HG, especially if prolonged or refractory to the traditional management. Modified, high dose, non-teratogenic dual therapy for eradication of Helicobacter pylori could be considered to relieve HG in intractable cases with negligible side effects.