The explosion of new information on Helicobacter pylori-related disease, both in the basic sciences and in clinical medicine, has continued to progress at an unprecedented pace. In many instances H. pylori infection, both in man and in the laboratory animal, has become a model to investigate fundamental biological issues such as micro-organism-host interactions, intracellular signalling, development of mucosal atrophy, mechanism of microbial resistance, disease modifying factors etc. In view of this bewildering flood of new information, the time was considered right to organize yet another update on H. pylori in the successful series 'Basic mechanisms to clinical cure' to define the 'state-of-affairs' in H. pylori research at this time. Our main objective was to integrate this new information in a series of top-quality presentations and discussions between investigators and clinicians, addressing all aspects of H. pylori research, and to review the current position and future research direc tions. The format included state-of-the-art presentations by world experts heavily involved in H. pylori research, followed by in-depth discussion on intriguing or controversial issues. The topics discussed were grouped according to the leading theme: characteristics of the organism, mode of transmission, mechanisms of H. pylori-induced inflammation, causation of disturbances of gastric secretory and motor function, aspects of clinical presentation and management, problems related to H. pylori-associated gastric adenocarcinoma and MALT-lymphoma, novel aspects of antimicrobial therapy, and vaccination. The meeting concluded with a synoptic agenda of suggested future studies for the microbiologist, the histopathologist and the clinician.