Helicobacter pylori infection has various clinical manifestations including peptic ulcer. However, over 80% of H. pylori colonization in the stomach is asymptomatic. The increased erythrocyte sedimentation rate is one of the markers of infection and can be an indicator of H.pylori infection in children. To investigate the association between erythrocyte sedimentation rate and H.pylori gastritis in children. This study is an analytic observational cross-sectional design in pediatric patients who experience recurrent abdominal pain in outpatient and inpatient gastroenterology units at the Universitas Sumatera Utara hospital and network hospitals from October 2020 – January 2021. Children with cognitive impairment, history of malignancy, autoimmune disease, pulmonary infection, and dehydration were excluded from the study. All subjects underwent endoscopy, campylobacter-like organism (CLO), and erythrocyte sedimentation rate for diagnosis. The relationship between H. pylori gastritis and erythrocyte sedimentation rate was analyzed using the Chi-square test. A total of 52 children were included in this study; about 32 were positive and 20 were negative for H. pylori infection. The erythrocyte sedimentation rate examination showed that 78.1% of the population was positive and 45% of the population was negative for H. pylori with abnormal erythrocyte sedimentation rates. Chi-square test showed that there was a significant (p=0.015) between erythrocyte sedimentation rate and H.pylori infection and children with H.pylori infection tended to have an increase in erythrocyte sedimentation rate. There is a significant association between erythrocyte sedimentation rate and H. pylori gastritis infection in children.