Background: Helicobacter pylori (H. pylori) infection is a major cause of chronic gastritis, especially in metabolic syndrome patients. The use of a accessible and easy diagnostic method, can speed up the treatment of this infection This study compared two methods of histology and serology for diagnosis of H. pylori in metabolic syndrome patients.Methods: This study was done on 175 metabolic syndrome patients with dyspepsia referred to Shahroud Imam Hossain hospital in 2014. From each patient, standard biopsy and serology tests were taken with endoscopy. This data will be analyzed with sensitivity, specificity, positive and negative predictive value.Results: Of the 175 patients studied, 90 (51.4%) were male and 85 (48.6%) were female. The mean patient age was 46.9±18.6 years. From 175 patients, 114(65.1%) and 149 (85.3%) patients tested positive by serology and histology, respectively. For the serological test, sensitivity, specificity, positive predictive value and negative predictive value were 66.4%, 42.3%, 86.8%, and 18.1%. It was also found that with IgG values higher than 1.3, there was a sensitivity of 90.7%, and specificity of 72.8%, which was considered a positive test. The cut-off point performance test means that maximum at this point with 78.3% the area under the curve (AUC), there is the highest sensitivity and specificity.Conclusions: Due to the relative sensitivity and specificity of serological tests in comparison with other diagnostic methods as well as the simplicity, speed, and low cost, it is recommended that this test be used for screening metabolic syndrome patients