OBJECTIVE To confirm whether eradication of H. pylori is associated with the occurrence of gastroesophageal reflux disease (GERD). METHODS We searched multiple medical databases for published randomized controlled trials (RCTs) from 2000 to 2012 comparing the incidence of GERD in adult patients receiving H. pylori treatment and those without treatment. The effects of H. pylori eradication were analyzed by calculating the pooled estimates for the number of new cases of GERD. Each racial subgroup of patients was analyzed using risk ratio (RR) by fixed effects models. The publication bias was assessed with funnel plot, Egger and Begg's test. RESULTS Sixteen eligible RCTs were finally included in the analysis. Statistically analysis suggested H. pylori eradication was significantly correlated with the occurrence of GERD (RR 1.89, 95% CI 1.50-2.40). Funnel plot, Egger or Begg's test revealed no publication bias. CONCLUSIONS H. pylori may have a positive effect on GERD especially in Asian patients and those with long-term follow-up, and eradication of H. pylori may cause GERD.