Objective To explore the clinical value of gastric background mucosal examination under scaled digestive endoscopy in judging Helicobacter pylori (Hp) infection. Methods Ninety-seven patients who underwent gastroscopy in the outpatient and inpatient clinics of Yangjiang Traditional Chinese Medicine Hospital from October 1, 2019 to September 1, 2021 were selected as research objects. The entered study cases were examined by the Endoscopic Background Mucosal Examination Scale and 13C-urea breath test (13C-UBT), histological examination of gastric mucosa, with the results of gastric mucosal histological examination as the gold standard, compared the diagnostic performance of the two methods.Results Among the 97 patients,88 were pathologically confirmed to be positive for Hp infection,and 9 were non-positive for Hp infection. 13C-UBT detection results confirmed that 85 patients were positive for Hp infection, and 3 were negative. Endoscopic Background Mucosal Examination Scale detection results confirmed that 83 patients were positive for Hp infection, and 5 were negative. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the Endoscopic Background Mucosal Examination Scale were 94.32%, 77.78%, 97.65%, 58.33%and 92.78%, while the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 13CUBT were 96.59%, 88.89%, 98.84%, 72.73% and 95.88%, and the differences were not significant (P＞0.05). Conclusion The gastric background mucosal examination under the scaled digestive endoscopy has good diagnostic performance in judging Hp infection, the score is clear, the standard is easy to grasp, and the practicability is strong.