The article provides a detailed analysis of the provisions of the Kyoto consensus on the classification of chronic gastritis. Particular attention is paid to the etiological role of Helicobacter pylori. The authors presented the results of their own study of the microbial “landscape” of the gastric mucosa. The role of Helicobacter pylori, atrophy and metaplasia of the gastric mucosa in the development of gastric cancer, as well as other etiological variants of chronic gastritis: alcoholic, medicinal, etc. are discussed. Critical assessment of the main provisions of the Kyoto consensus was made.