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Background/Aim: The aim of this study was to investigate the role of the platelet-to-lymphocyte ratio (PLR)–neutrophil-to-lymphocyte ratio (NLR) combination, in the prediction of the presence of Helicobacter pylori (HP) and its associated complications in the gastrointestinal system. Patients and Methods: In all, 1289 patients who underwent esophagogastroduodenoscopy and biopsy for HP were included in the study. Results: The ratio of patients with moderate and severe chronic gastritis was higher in HP (+) group than HP (−) group. The ratio of patients with levels 1–3 atrophy and intestinal metaplasia was higher in HP (+) group. Compared with HP (−) group, HP (+) had higher PLR and NLR levels. The ratio of HP (+) patients was higher in high-risk group compared with low- and medium-risk groups. HP invasion stage, the intestinal metaplasia level, and the ratio of patients with atrophy level “3” were higher in high-risk group compared with low- and medium-risk groups. Regression analysis showed that the PLR–NLR combination was an independent risk factor for both HP presence and moderate and severe chronic gastritis. Conclusion: We found the PLR–NLR combination to be a good predictor of HP presence and gastrointestinal complications associated with HP.