ABSTRACT Objectives: To establish the rate of Helicobacter pylori reinfection in children from an H. pylori high prevalence area, possible clinical features predictive of reinfection and the usefulness of re‐treatment. Methods: 65 consecutive children attending the authors' department between 1998 and 2000 who had proven successful H. pylori eradication were enrolled; 52 took part. Patients and family members were invited to undergo 13 C‐urea breath testing and to complete a simple questionnaire regarding symptoms and socioeconomic status. Patients with H. pylori reinfection were offered treatment; eradication was assessed by 13 C‐urea breath test 8 weeks after completion of treatment. Results: Of 52 children, 15 (28.8%) were H. pylori positive. Variables predictive of reinfection were age at primary infection and presence of an infected sibling. Although reinfected children were more frequently symptomatic than non‐reinfected patients, no specific symptom was associated with reinfection. Of the nine re‐treated patients who returned 8 weeks after completing therapy, the bacterium was eradicated in five (56%). Conclusions: The 12.8% per year reinfection rate in childhood at 2 years that we observed should prompt a re‐evaluation of H. pylori status even after a successful eradication. Living in an H. pylori high prevalence area increases the annual risk of reinfection by approximately fourfold over the annual risk in H. pylori low prevalence areas.