 The pathogenesis and disease outcomes of helicobacter pylori are determined by a complex interplay between bacterial, host, and environmental factors. For critical steps for successful colonization, persistent infection, and disease pathogenesis includes survival in the acidic stomach, movement toward epithelium cells, attachment to host cells, and tissue damage caused by toxin release. Recent studies have improved our understanding of H. pylori pathogenesis through epidemiology research, molecular mechanism investigations, and gene regulatory network analysis. Key findings include the roles of novel virulence factors such as bacterial adhesins, CAG pathogenicity island, and vaculating cytotoxin, which are associated with different disease outcomes. A complete genomic database of H. pylori strains is helpful in characterizing this bacterium. This article was authored by Cheng Yancao, Borshain Xu, and Jianjiang Wu. We're article.tv, links in the description below.