H. pylori is associated with the majority of gastric cancer cases globally and is responsible for a large burden of morbidity and mortality from chronic gastritis and peptic ulcer disease. Despite a recent trend in reducing prevalence, it continues to pose a major threat to human health worldwide. With a full understanding of the current prevalence, risk factors, characteristics of the infection, and at-risk populations, we can better target screening and diagnostic strategies to maximize eradication and improve clinical outcomes. In the last year, studies on the prevalence of H. pylori infection in different regions have shown that rates are decreasing in many parts of Asia, particularly in urban China, but remain high, ranging from 40% to 80%, across the African continent. Despite differences in these factors by geography, risk factors such as socioeconomic status, hygiene, and diet remain evident and play a crucial role in reducing transmission and reinfection. The prevalence of antimicrobial resistance, particularly multidrug-resistant bacteria, and genetic mutations associated with virulence now approaches a plurality of infections, underlining the importance of ongoing strong local evidence to support eradication therapies and antimicrobial stewardship.