Background: Dyspeptic symptoms are the most common presenting complaints of patients attending Gastroenterology OPD. Histomorphological features seen in gastric biopsies include H.Pylori associated chronic and atrophic gastritis, gastric ulcer, gastric atrophy, intestinal metaplasia and gastric carcinoma. Early detection of these histomorphological features helps the physician to plan further treatment and prevent its complications. Objective: To study various histomorphological changes and their prevalence in gastric biopsy specimens taken from dyspeptic patients aged more than 18 years with visual endoscopic changes. Materials and methods: A cross sectional study conducted in Dr SMCSI medical college hospital, which included gastric biopsy specimens from dyspeptic patients, aged more than 18 years with visual endoscopic changes.¬¬ H&E stained sections were examined for the associated histomorphological changes. Results: Majority of the cases (43.3%) showed chronic gastritis. 35.3% of the cases showed H.Pylori positivity. H.Pylori was seen in 47.9% of chronic gastritis, 66% of gastric carcinoma, 50% of gastric polyps, 16.7% of cases with intestinal metaplasia and 71.4% of cases with atrophy. Conclusion: Helicobacter pylori infection is associated with chronic gastritis, gastric ulcer, gastric atrophy, intestinal metaplasia, adenocarcinoma and gastric MALT lymphoma. Early detection of these histological features and eradication of Helicobacter pylori not only improve the symptoms but also help to prevent complications associated with H.pylori infection