Helicobacter pylori infection is much more prevalent in people with learning disabilities than in the general population. It can have negative effects on people’s health and well-being, including gastritis, gastric ulcers and gastric cancer. It is also likely to be a precipitating factor in aspiration pneumonia, which is the leading cause of death in the learning disability population. In recent years, a community learning disability team has supported the diagnosis and treatment of H. pylori infection in the people it cares for by identifying signs and symptoms and requesting testing from GPs. This article describes the prevalence, adverse effects, signs and symptoms, testing and treatment of H. pylori infection. It also discusses 14 patients from the team’s caseload and considers unresolved questions about testing and treatment.