Occurrence of the bacterium Helicobacter pylori was compared for two Costa Rican sites with contrasting levels of gastric cancer incidence, Poás (incidence 15.13%) and Puriscal (83.53%). A sample of 185 adults of similar age and sex proportions was studied in each site, using both H. pylori antiserum tests and gastroscopy to collect two biopsies per case. No clear association between H. pylori and gastric cancer was found.