We estimated the prevalence of Helicobacter pylori infection, chronic gastritis, atrophy, and intestinal metaplasia in dyspeptic patients from Maputo Central Hospital, Mozambique and evaluated the relationship between infection and histopathological features of chronic gastritis. Biopsies from 109 consecutive patients observed in 2005-2006 were collected from antrum, incisura angularis, and corpus for histopathological study according to the Modified Sydney system. H. pylori infection was assessed by histology and polymerase chain reaction. H. pylori prevalence was 94.5%. Chronic gastritis was the most frequent diagnosis (90.8%). Degenerative surface epithelial damage was associated with higher H. pylori density. Glandular atrophy (8.3%) and intestinal metaplasia (8.3%) were infrequent. Our results confirm previous observations in African countries with high prevalence of H. pylori infection and low rates of gastric cancer: high frequency of chronic H. pylori-associated gastritis with very low frequency of gastric atrophy and intestinal metaplasia.