Abstract: OBJECTIVE To analyze the histopathological and endoscopic findings of 128 chronic gastritis patients with Helicobacter pylori infection and study the genetic susceptibility.METHODS A total of 128 H. pylori-positive patients with chronic gastritis who were treated in endoscopy center of Wuhan Eighth Hospital from Jan 2019 to Oct 2020 were assigned as the positive group, and 128 H. pylori-negative patients with chronic gastritis were chosen as the negative group. The results of gastroscopic examination, histopathological examination of gastric mucosa and test of peripheral blood TLR gene polymorphisms were compared between the two groups of patients.RESULTS The proportions of the patients who had gastroscopic manifestations such as regularly arranged collection of veins, linear erythema, fundus gland polyps and spotting bleeding were significantly higher in the positive group than in the negative group（P＜0.05）; the proportions of the patients who had fold hyperplasia, punctate erythema, exudation and atrophy were significantly higher in the positive group than in the negative group（P＜0.05）. The patients of the positive group were mainly characterized by chronic inflammatory changes and blue and curved shafts. The incidence of mild inflammation of the positive group was significantly lower than that of the negative group（P＜0.05）, the incidence of severe inflammation of the positive group was significantly higher than that of the negative group（P＜0.05）, the incidence rates of positive lymphocytes and positive lymphoid follicles of the positive group were higher than those of the negative group（P＜0.05）. There were no significant differences in the frequencies of GG genotype, GA genotype, allele G and allele A at rs4833095 locus of TLR1 gene between the positive group and the negative group; the frequency of AA genotype of the positive group was significantly higher than that of the negative group（P＜0.05）.There were no significant differences in the frequencies of TT genotype, TA genotype, allele T and allele A at rs10004195 of TLR10 gene between the positive group and the negative group, and the frequency of AA genotype of the positive group was significantly higher than that of the negative group（P＜0.05）.CONCLUSION The major gastroscopic manifestations of the patients with H. pylori infection include fold hyperplasia, spotted erythema, exudation and atrophy. Severe inflammation and lymphocytes infiltration are the predominant histopathological findings. The AA genotype at rs4833095 locus of TLR1 and rs10004195 locus of TLR10 may be the potential influencing factor for the H. pylori infection.