Recurrent peptic ulcer disease has traditionally posed problems for practicing physicians. While many treatment options have been promoted in the past, recent understanding of the role of Helicobacter pylori has completely altered our approach to this clinical problem. Since most ulcers are related to H. pylori infection or to ingestion of aspirin or non-steroidal anti-inflammatory drugs, improved understanding of these factors and the development of rational treatment approaches should limit recurrent peptic ulceration in the future. This should help improve our patients' quality of life and should have a positive economic impact on the long-term treatment of peptic ulcer by reducing the requirement for continuous medical treatment. The issue of recurrent peptic ulceration and some approaches to management are discussed in this article.