<span name="style_bold">Objective: </span>This review aims to show the latest elements that support the environment as a possible vector or reservoir of Helicobacter pylori, under a scenario of multiple pathways, and very closely related to drinking water. <span name="style_bold">Method: </span>The paper presents an analysis of information that corresponds to a systematic and evaluative review. The search method and location corresponded to the use of the PubMed Central computerized database as well as the Ingenta search system. <span name="style_bold">Results: </span>More than 5 800 articles containing the word Helicobacter pylori in English in the last 8 years were reviewed. From these articles only 2% met evidence standards required to be incorporated in the topic of this review. <span name="style_bold">Conclusion: </span>It can be concluded that an increasing number of researchers worldwide are open to the idea of an environmental role in the epidemiology of Helicobacter pylori infection and the only missing element is obtaining cultures of viable strains. Up to now, the only way to provide evidence of the presence of this bacterium is the use of molecular techniques.It can be concluded that an increasing number of researchers worldwide are open to the idea of an environmental role in the epidemiology of Helicobacter pylori infection and the only missing element is obtaining cultures of viable strains. Up to now, the only way to provide evidence of the presence of this bacterium is the use of molecular techniques.

Helicobacter pylori; gastric cancer; epidemiology; drinking water; biofilms; socioeconomic factors