Abstract: Objective：To explore the clinical application value of Helicobacter pylori stool antigen (HpSA) test in patients with upper gastrointestinal bleeding. Methods：A total of 101 patients with gastrointestinal symptoms who underwent gastroscopy at the Taixing People’s Hospital Affiliated to Bengbu Medical College from April 2015 to May 2016 were selected. Gastric mucosa rapid urease test (RUT), HpSA test and gastric mucosa Hp PCR detection were used. The RUT result was used as the "gold standard" for diagnosing Hp infection, and the results of HpSA test and PCR detection were compared with it. Results：With RUT as the gold standard for the diagnosis of Hp infection, the sensitivity of HpSA was 86.67% (52/60), the specificity was 95.12% (39/41), the positive predictive value was 96.30% (52/54), the negative predictive value was 82.98% (39/47), and the accuracy was 90.10% (91/101). The sensitivity of PCR detection was 80% (48/60), the specificity was 97.56% (40/41), the positive predictive value was 97.96% (48/49), the negative predictive value was 76.92% (40/52), and the accuracy was 87.13% (88/101). The consistency of HpSA test and PCR detection with RUT were compared, and the values of Kappa were 0.80 and 0.74, respectively. Conclusions：HpSA test is highly consistency with the gold standard and reliable in detecting the upper gastrointestinal hemorrhage, so it is an ideal method for noninvasive diagnosis of Hp infection.