BackgroundObesity has become a major health concern associated with several comorbidities. Obesity has been connected to numerous variables. Furthermore, multiple studies were done worldwide to identify the relationship between obesity and Helicobacter pylori (H. pylori), and there was controversy. However, the relationship between H. pylori infection and obesity in our community is still not clear, and there is a knowledge gap.AimTo determine the relationship between asymptomatic H. pylori infection and body mass index (BMI) among patients who underwent bariatric surgery in Saudi Arabia, King Fahad Specialist Hospital - Buraidah (KFSH-B).MethodAn observational retrospective cohort study was conducted at KFSH-B. Patients with high BMI (>30 kg/m2) who underwent bariatric surgery between January 2017 and December 2019 were included. Gender, age, BMI, and upper GI endoscopy reports of preoperative mapping were collected from electronic health records.ResultsThe sample size was 718, and the mean BMI (standard deviation) was 45 kg (6.8). Patients with positive H. pylori results were 245 (34.1%) and patients with negative H. pylori results were 473 (65.9%). The t-test showed the mean BMI of patients with negative H. pylori results to be 45.36 (SD 6.6). Positive H. pylori 44.95 (SD 7.2) p-value was not significant (0.44).ConclusionThe data showed that patients who had undergone bariatric surgery had negative pre-operative histopathological results of H. pylori more than those who had positive results, which is consistent with the prevalence of H. pylori infection among the general population. Therefore, we found no correlation between H. pylori infection and high BMI.