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<b>Background/Aim:</b> The published data on <i> Helicobacter pylori</i> (<i> H. pylori</i> ) prevalence and its relationship with abdominal pain in Saudi Arabia is scarce. This study was carried out to determine the prevalence of <i> H. pylori</i> and its relationship with chronic recurrent abdominal pain (RAP) among school students in Makkah City, Saudi Arabia. <b> Materials and Methods:</b> Three hundred and fourteen school students, 103 at the intermediate level (grades 7-9) aged 12-15 years and 211 at the secondary level (grades 10-12) aged 15-18 years were tested for <i> H. pylori.</i> Urea breath test (UBT) was used for this purpose. Children with chronic RAP were identified as per the Apley criteria. <b> Results:</b> Overall, the UBT was positive in 86/314 (27.4&#x0025;) students. It was positive in 45/103 (43.7&#x0025;) intermediate school students and 41/211 (19.4&#x0025;) secondary students. Out of the 55 students with chronic RAP, 40 (73&#x0025;) were positive for <i> H. pylori</i> . Further, 62.9&#x0025; and 82.1&#x0025; were positive among the intermediate and secondary school students with RAP, respectively. The overall and specific odds ratios of RAP were 12.35 [95&#x0025; confidence interval (C.I.) 6.30-24.22] and 10.40 (95&#x0025; C.I. 1.75-11.73) for the intermediate school students and 22.69 (95&#x0025; C.I. 7.99-64.44) for the secondary school students. <b> Conclusion:</b> The prevalence of <i> H. pylori</i> among the school children in Makkah, Saudi Arabia, is relatively low compared with developing countries. The prevalence was found to be higher among the younger age group. Further, there was a significant relation between <i> H. pylori</i> infection and RAP among the school students.