The study objective was to investigate prevalence and determinants of current Helicobacter pylori infection in an asymptomatic population of middle-aged to elderly people. A cross-sectional study was conducted among 337 participants of a general education programme of the University of Ulm aged 50–85 years. Prevalence of infection as determined by means of the [13C]urea breath test was 34·8% (95% CI 29·6–40·3%) ; overall, 33·8% (95% CI 23·0–46·0) in the age group 50–59 years, 32·4% (95% CI 25·4–39·9) in the age group 60–69 years and 41·0% (95% CI 30·0–52·7) in the age group 70–85 years. Duration of school education of the father, sharing a bed with parents or siblings during childhood, and the area in which participants had grown up were independent determinants of current infection status in a multivariable analysis. We conclude that the prevalence of current H. pylori infection in healthy elderly subjects may not be as high as seroprevalence studies have suggested. Socioeconomic characteristics of childhood living conditions appear to be important determinants of infection status even at older age.