Background: Helicobacter pylori infection is a major cause of chronic gastritis in hemodialysis patients. There are various methods for diagnosis of infections with this organism. This study compared two methods of histology and serology for diagnosis of Helicobacter pylori in hemodialysis patients.Materials and methods: This study has been done on 75 hemodialysis patients with dyspepsia referred to Imam Hossain Hospital of Shahroud, Iran in 2014. Endoscopy with standard biopsy and serology test were done for all patients. Sensitivity, specificity, and positive and negative predictive value were evaluated for serology test.Results: From 75 patients with dyspepsia, 49 patients (65.3%) had positive serology test, and 64 (85.3%) patients were positive by histologic findings. Sensitivity, specificity, positive predictive value, and negative predictive value were 70.3%, 63.6%, 91.8% and 26.9%, respectively.Conclusion: Due to the relative high sensitivity and specificity of serological tests in comparison with other diagnostic methods, as well as its simplicity, speed and low cost, it is recommended to use this test for screening of hemodialysis patients.