Background: Helicobacter pylori is known to cause gastric cancer. Presence and carcinogenicity in the upper aerodigestive system is doubtful. This study examined the prevalence of Helicobacter pylori and related factors in biopsies from the upper aerodigestive tract in patients with gastric colonization by Helicobacter pylori. Methods: In a case series study, 26 patients with histopathologically confirmed gastric colonization were identified. A polymerase chain reaction was performed on matched formalin-fixed and paraffin-embedded tissues of the stomach and the oral cavity, pharynx, or larynx. Results: Helicobacter pylori was found in 38% of the samples from the oral cavity, larynx and pharynx. An association with malignancies in these regions or possible risk factors such as age, smoking, or alcohol was not found. Conclusion: The upper aerodigestive system seems to be an additional reservoir in a significant percentage of patients presenting with Helicobacter pylori gastritis. Head Neck, 2013.