AIM: To analyse the spectrum of various upper gastrointestinal lesions and their association with H.pylori in patients with complaints of dyspepsia. MATERIALS & METHODS:The study was conducted at a tertiary care centre, in Salem district, Western part of Tamilnadu, South India, included 2136 patients over a period of three years. Endoscopic gastric mucosal biopsies were taken and stained with Giemsa stain to identify H.pylori infection. RESULTS: The most common upper GI lesion encountered in endoscopy  was Pan gastritis (51%).Overall prevalence of H.pylori was 63% ,and it was significantly associated   with 84% of Duodenal ulcer,71% of Bulbar duodenitis and 70% of Pangastritis. CONCLUSION:Prevalence of H.pylori is high in this region. Early upper GI endoscopy is mandatory in all dyspeptic patients and they should be tested for H.pylori infection so that prompt treatment can be started to reduce the incidence of various H.pylori induced upper GI diseases.