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<i>Background and Objectives</i>: The prevalence of <i>H. pylori</i> in Eastern Europe remains quite high; however, there is insufficient data on the eradication regimens and their effectiveness. Therefore, the objective of the study was to evaluate the diagnostic methods and treatment of <i>H. pylori</i> infection as well as their adherence to Maastricht V/Florence consensus during the years 2013–2020 in Lithuania. <i>Materials and Methods</i>: Sub-study of the “European Registry on <i>H. pylori</i> Management” (Hp-EuReg), international multicenter prospective non-interventional registry of the routine clinical practice. Lithuanian data from the years 2013–2020 were analyzed for effectiveness on a modified intention-to-treat (mITT) basis. 2000 adult patients, diagnosed with <i>H. pylori</i> infection, were included. Data were compared to the European Maastricht V guidelines. <i>Results</i>: Triple-therapy was used in 90% of the cases. In 91% of the first-line prescriptions, standard triple therapy (STT) was used. The most common second-line treatment was a combination of PPI, amoxicillin and levofloxacin (PPI+A+L) (47%). The overall effectiveness in 552 cases valid for analysis was 90% by mITT. In first-line treatment, the STT effectiveness was 90% and second-line treatment with PPI+A+L achieved 92% by mITT. Increasing overall <i>H. pylori</i> eradication rates were observed: from 72% in 2013 to more than 90% in 2018–2020, as well as a shift from 7 to 10–14 days treatments duration throughout 2013–2020. <i>Conclusions</i>: In Lithuania, the prescribed eradication regimens for <i>H. pylori</i> were in accordance with the international guidelines but diagnostic methods and treatment duration only partially met Maastricht V/Florence guidelines. The eradication effectiveness was improved progressively during the years 2018–2020, reaching ≥90% cure rates.