Objective: Half of the world’s population is infected with Helicobacter pylori (H. pylori), which can cause gastric diseases and must be eradicated. The reinfection rate, the colonization rate with a new strain usually after more than 12 months of successful eradication, is considered higher in developing countries than developed countries due to lower investment in sanitation and hygiene or a higher population density. The study aimed to analyze and understand H. pylori recurrence rates in developed and developing countries and compare the results from 2013 to 2023 to those between 1992 and 2006.

Patients and Methods: PubMed, Google Scholar, Embase, and Scopus databases were searched up to December 31, 2023, using the keywords “Helicobacter pylori” or “H. pylori” and “recurrence” or “recrudescence” or “reinfection”. Clinical studies examining the recurrence rate of H. pylori following successful eradication therapy were included, specifically those that provide clear, quantifiable results for comparison. Meta-analysis was performed with comprehensive meta-analysis software, version 4 (Biostat Inc., Englewood, NJ, USA).

Results: 5,808 articles were screened and 20 articles (35 data sets with 16,785 participants) from 11 countries were finally enrolled for analysis. The annual recurrence rate ranged from 0% to 18.80%. The annual reinfection rates in developing and developed countries were 0.040, 95% CI 0.030 to 0.052, and 0.030, 95% CI 0.018 to 0.051, respectively.

Conclusions: No significant change in the recurrence rate between developed and developing countries was demonstrated, possibly due to better hygiene status in developing countries as achieved in the last decade.