The resistance of Helicobacter pylori (H. pylori) to antibiotics leaves great influence on treatment outcome. Agar and broth dilution techniques are difficult to perform and not practical. E-test has the advantage of allowing visualization of resistant subpopulations of bacteria within zones of inhibitions. We studied point mutation of 23s-rRNA gene for H. pylori strains. (74 clarithromycin (CAM)-resistant, 6 CAM-susceptible) The results of these assays were well correlated with these of E-test. The cure rate of triple therapy with metoronidazole (MTZ) for CAM-resistant H. pylori is 100%(11/11), and that with CAM for MTZ-resistant H. pylori is 94.4% (17/18). It is very difficult to eradicate CAM and MTZ-resistant H. pylori.