Chronic urticaria (CU) is a common skin disease characterized by widespread, transient wheals occurring daily or almost daily for at least 6 weeks. Chronic urticaria caused by Helicobacter pylori can be cured after H. pylori quadruple regimen. A 31-year-old male with a past medical history of mild intermittent asthma presented with a complaint of chronic pruritus with diffuse urticarial wheals for the past seven months. Allergy history was unremarkable. He underwent an extensive work up including complete blood count, basic metabolic panel, HIV, thyroid stimulating hormone, thyroid peroxidase antibodies, serum IgE level, environmental allergy testing, and chest X- ray and all were negative. He was started on cetirizine and ranitidine with mild improvement, however his symptoms persisted. Four weeks later, he complained of epigastric pain and was subsequently tested for H.pylori by stool antigen which resulted as positive. He was treated with bismuth subsalicylate, metronidazole, tetracycline and omeprazole for two weeks. Pruritus and urticarial wheals disappeared in four weeks after therapy was started. Repeat stool H. pylori was done in eight weeks to confirm eradication. It was negative and no recurrence of urticaria was noticed. Chronic urticaria and dyspepsia are associated with H. pylori and its presence can be tested for by using an affordable, noninvasive, sensitive and specific test such as H. pylori stool antigen. The case demonstrates that H. pylori should be included in the diagnostic work-up of chronic urticaria, especially in patients without response to habitual treatment for chronic urticaria or those with concomitant gastrointestinal symptoms.