Objective: A prospective study was performed to compare the relation of macroscopic appearance of gastric/duodenal mucosa with the histological findings and Helicobacter pylori (H.pylori) positivity in dyspeptic patients.Methods: Endoscopic examination was done in 116 consecutive patients with dyspeptic symptoms. Thirty of those 116 patients having overt peptic ulcer findings were excluded from the study. Of the remaining 86 patients, 63 was found to have mucosal abnormality on histological investigation.Results: Endoscopy detected gastric/duodenal mucosal lesions in 35 of those 63 patients with histologically confirmed abnormality but misinterpreted the remaining 28 as normal (sensitivity55.5 %). Endoscopy evaluated accurately 14 of 23 patients, all with normal histological findings, as normal, however, misdiagnosed the remaining 9 as gastritis/duodenitis (specificity 60%). H. Pylori was isolated from 88.8% of patients with histologically confirmed mucosal abnormality