Background/Aims: It remains controversial whether Helicobacter pylori (H. pylori) infection is related with recurrent abdominal pain (RAP). CagA or VacA-positive H. pylori may be associated with peptic ulcer and gastric cancer. Reports on this association are different according to geographic areas. There is little to be known about the relation of RAP with CagA serology. The aims of this study were to examine the relation of RAP with H. pylori infection and to investigate the association of CagA and VacA with RAP in the case of pediatric H. pylori infection. Methods: A total of 753 children aged from 6 to 12 years were enrolled. H. pylori IgG antibody was measured by ELISA. IgG antibody to CagA and VacA was tested by Western blot. Results: Of the 753 children, 36 (4.8%) were seropositve for H. pylori and 53 (7.0%) showed RAP. There were no differences in number of siblings, crowding, socioeconomic status between H. pylori-seropositive and H. pylori-seronegative group. The seroprevalence of H. pylori was 9.4% in the children with RAP and 4.4% in the healthy children (p=0.1). Among H. pylori-seropositive children, anti-CagA antibody was present in 100% of children with RAP and 93.5% of asymptomatic children. Among them, anti-VacA antibody was present in 56.2% of children with RAP and 58.1% of asymptomatic children. Conclusions: There is no evidence for association between RAP and H. pylori infection. CagA or VacA is not associated with development of RAP in H. pylori infection. (Korean J Gastroenterol 2001;37:167-172)