Helicobacter pylori (H. pylori) relationship with humans is believed to have originated in Africa and three African H. pylori populations have been identified: hpAfrica1, hpAfrica2 and hpNEAfrica. Actually, H. pylori infection is a ubiquitous infection in developing countries, particularly Africa. In this continent, the prevalence of H. pylori is higher and the bacterium is acquired at an early age compared to developed countries. In fact, while it affects over 50% of humans in developed countries its prevalence reaches 80% or more among adults in Africa. This paper reviews works in literatures, including epidemiology, virulence genes, gastric pathology and antimicrobial treatment and resistance of H. pylori in Africa.