Objective: To evaluate the value of endoscopic image classification according to kyoto in the diagnosis of helicobacter pylori infection in patients with gastric disease. Subject and method: A cross-sectional descriptive study was conducted on 79 patients with gastric disease at Thai Nguyen from August 2023 to June 2024. Endoscopic findings were assessed using the Kyoto classification. Results: Atrophy (32.9%), diffuse redness (26.6%), xanthoma (16.5%), mucosal swelling (31.6%), enlarged folds (15.2%), sticky mucus (19.0%), nodularity (15.2%) are associated with H. polyri infection. For those not infected with H. pylori associated red streak (27.8%), hematin (12.7%) and RAC (65.8%). Map-like redness (30.4%), multiple white and flat elevated lesions (35.4%), and intestinal metaplasia (13.9%) were associated with past infection. The Kyoto scale with a cut-off point for H. pylori diagnosis of 2 gives a high AUC (0.810 with p < 0.05), sensitivity and specificity of 69.6% and 87.9%, respectively. Conclusions: Individual endoscopic feature in the Kyoto classification has low diagnostic value for H. polyri infection. The Kyoto score has high value in predicting H. pylori infection in patients with gastric disease. Keywords: Helicobacter pylori, Kyoto classification, gastric disease.