Objective: Helicobacter pylori (H. pylori) infection drives major gastroduodenal pathologies. Although isolated clinical studies exist in Ukraine, a comprehensive synthesis is lacking. This systematic review and meta-analysis aimed to estimate the pooled proportion of H. pylori-positive individuals in Ukrainian clinical cohorts and to explore inter-study heterogeneity.

Materials and Methods: Following PRISMA guidelines, PubMed, Scopus, Web of Science, and domestic databases were searched for observational studies reporting H. pylori prevalence in Ukraine. Pooled prevalence and 95% confidence intervals (CIs) were calculated using a random-effects model with logit transformation (PLOGIT). We evaluated heterogeneity using the I² statistic. Subgroup analyses, meta-regression, and sensitivity analyses (leave-one-out, trim-and-fill) were conducted.

Results: Twenty-seven studies met the inclusion criteria. Among 21 studies involving 6,492 patients with gastrointestinal pathologies, the pooled H. pylori prevalence was 76.5% (95% CI: 68.5-82.9%). A separate analysis of six studies (n = 458) on extragastric conditions yielded a prevalence of 69.1% (95% CI: 52.4-81.9%). Inter-study heterogeneity was consistently high across both groups (I² = 92.2% and 87.8%, respectively; p < 0.001). Subgroup analysis and meta-regression showed that diagnostic method (active vs. serological/combined) was not a statistically significant moderator of prevalence (p = 0.171). Sensitivity analyses confirmed the stability of the pooled estimates without dominant mathematical impact from individual studies. Egger’s test (p = 0.777) suggested no significant publication bias, though selection bias remains prominent.

Conclusions: H. pylori detection rates are exceptionally high among Ukrainian clinical cohorts, underscoring the need for accessible, validated diagnostics in indicated patient groups. However, substantial heterogeneity and pronounced selection bias prevent extrapolation of these descriptive estimates to the general population. Determining the true national burden necessitates purposefully designed population screening.