Non-steroidal anti-inflammatory drugs (NSAIDs) are now widely used medicines and their relationship with gastroduodenal injury is well established. The overall risk for serious gastrointestinal side effects in patients taking NSAIDs is three times greater than that of control groups and this risk rises to more than five times in elderly patients. Moreover, the risk of gastrointestinal surgery is ten times greater in elderly patients taking NSAIDs than in controls. Therapeutic aspects like the necessity of eradication of Helicobacter pylori (H. pylori) in order to reduce the gastroduodenal risks for NSAIDs users, the indication for eradication of H.pylori of those with past history of peptic ulcer and require NSAID therapy, the role of eradication when the NSAIDs are used in association with misoprostol.