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The risk of study bias was assessed structurally using the ROBINS\u2010E tool. Data were pooled using a random\u2010effects meta\u2010analysis. The certainty of the evidence was assessed using the GRADE approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen studies comprising 30,650 patients and 291,908 controls were included. Exposure to <jats:italic>H. pylori<\/jats:italic> was associated with a significant reduction in the odds of EoE (pooled odds ratio [OR] 0.56; 95% CI, 0.46\u20130.70; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> 50%) [low\u2010certainty evidence]. The protective effect of <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> was stronger in case\u2013control studies (OR 0.49; 95% CI, 0.35\u20130.69) than in cohort studies (OR 0.76; 95% CI, 0.58\u20130.98) and was statistically significant in retrospective studies (OR 0.57; 95% CI, 0.45\u20130.72) and studies with high or very high risk of bias (OR 0.52; 95% CI, 0.42\u20130.64), but not in prospective studies (OR 0.56; 95% CI, 0.27\u20131.18) or those with moderate to low risk of bias (OR, 0.91; 95% CI, 0.69\u20131.21).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The association between <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> and EoE is mainly supported by retrospective studies with a high risk of bias. Further well\u2010designed studies are needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>PROSPERO number: CRD42024586653<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.70038","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T16:51:31Z","timestamp":1744995091000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Association Between <scp><i>Helicobacter pylori<\/i><\/scp> Infection and Eosinophilic Esophagitis: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0522-4129","authenticated-orcid":false,"given":"Luc\u00eda","family":"Guti\u00e9rrez\u2010Ram\u00edrez","sequence":"first","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria de Castilla\u2010La Mancha (IDISCAM)  Toledo Spain"},{"name":"Research Unit Complejo Hospitalario La Mancha Centro  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