Abstract: Objective To evaluate the need for gastroscopy in Helicobacter pylori infected individuals confirmed by health examination. Methods The database of endoscopy unit of Peking University First Hospital was used to select the individuals who underwent gastroscopy after being positive in urea breath tests in health examination from October 2012 to December 2016 to analyze their gastroscopic and pathologic manifestations and explore the relationship between the symptoms and ages. Results Among 919 individuals infected with H. pylori,the detection rates of chronic atrophic gastritis(CAG),gastric ulcer and duodenal ulcer were 37.6%,4.5% and 7.5%,respectively,and the detection rates of neutrophil infiltration,intestinal metaplasia, atrophy and dysplasia were 83.2%,30.3%,15.9% and 0.3%,respectively. There were no significant differences in gastroscopic and the pathological manifestations between the individuals with or without dyspeptic symptoms(P>0.05). The detection rate of CAG increased with ages(P<0.01),the proportion of CAG patients aged >40 years accounted for 89.6% of the total and multifocal atrophy was the major pathologic type. Conclusion H. pylori infection screening should cover all suitable adults, regardless of having dyspeptic symptoms or not. The detection rate of CAG was high in H. pylori infected individuals confirmed by health examination. It is necessary to conduct gastroscopy and follow up in H. pylori infected individuals aged >40 years.