We have analyzed the effect of treatment with colloidal bismuth subcitrate (CBS) and amoxicillin in a series of 60 children (age range: 2.9-18 years) infected by Helicobacter pylori (HP). The following results were found: clinical remission 70%; endoscopic normalization 55%; histological normalization 61.6% and HP eradication 53.3%. The improvement of histological activity (100% vs 11.7%) and histological normalization (90.6% vs 28.5%) were significantly more frequent in the HP eradicated group as compared with the persistent HP group (p < 0.001). The present study suggests that combined therapy with CBS and amoxicillin is not the most adequate treatment to eradicate HP in children and supports the role played by HP in the development of antral histologic lesions.