The aim of this study was to determine whether there is an association between Helicobacter spp. infection of the feline stomach and the presence of gastric lesions and epithelial proliferation within the mucosa of this tissue. The study included 23 pet cats of both sexes and of varied age and breed. Eighteen of these animals were clinically normal and five had a history of chronic vomiting. Samples of the mucosa of the pyloric antrum, corpus and fundus were collected by gastroscopy. The presence of Helicobacter spp. was confirmed by polymerase chain reaction (PCR) or Warthin-Starry (WS) staining and the species of Helicobacter was determined by PCR. Mucosal lesions were evaluated by examination of sections stained by haematoxylin and eosin (HE) and epithelial proliferation was determined by enumerating nucleolar organizer regions (AgNOR). In 20 (87%) cats the presence of Helicobacter spp. was confirmed by both PCR and WS. There was no significant difference in colonization density between the different gastric regions. H. heilmannii was the most frequently identified species (17 of 20 cats), and H. felis was only identified in co-infection (two of 17 cats). One sample that was PCR positive to the genus level for Helicobacter spp. was negative for the four individual species reactions. Histological changes in the lamina propria included mild mononuclear inflammatory infiltration, the presence of lymphoid follicles, fibrosis and glandular degeneration. These changes were most severe in the pyloric antrum. There was significant association between infection with gastric Helicobacter spp. and the presence of lymphoid follicles (P=0.03), and between infection and epithelial proliferation in the antrum (P<0.01), corpus (P<0.001) and fundus (P<0.001).