To investigate the prevalence of gastritis andH. pyloriinfection among young Chinese in Henan Province, a high incidence area for oesophageal cancer in China, the gastric mucosa was examined in 194 asymptomatic subjects, aged 15–26 years, in the course of an epidemiological study of precursor lesions of oesophageal cancer. Histopathological grading of gastritis and determination ofH. pyloriinfection were performed on haematoxylineosin and Warthin-Starry stained section. An enzyme-linked immunosorbent assay was used to detect the presence of serum IgG antibodies toH. pylori.A very high prevalence of gastritis (93.8%) was found: 71 subjects (36.6%) presented with superficial gastritis (14 active), 94 (48.5%) with diffuse gastritis (92 active) and in 17 cases (8.8%) diffuse gastritis (16 active) was accompanied by focal atrophy. Silver staining detectedH. pyloriin 166 (85.6%) of the study participants. However, serological techniques identifiedH. pyloriin only 109 (56.2%).H. pyloriwas seen in all the 119 cases showing histological signs of active gastritis, in 41 of the 63 cases (65%) without activity, and also in 50% (6/12) of histologically normal subjects.H. pyloriinfection was found to be associated with a 2.5-fold higher prevalence of chronic atrophic gastritis compared with non-atrophic gastritis. A family history of stomach cancer, consumption of pickled vegetables more than twice a month, and a high monthly salt consumption (> 500 g/ month) also showed a positive association. The widespreadH. pyloriinfection early in life, together with risk factors such as high salt consumption and a general nutritional inadequacy, appeared to contribute to a higher prevalence of chronic gastritis in young adults in China compared with Western countries.