Introduction: Pathogenesis of Eosinophilic esophagitis (EOE) is still not yet fully understood. Recent reports suggested that early life exposures as risk factor for EOE (hygiene hypothesis). An Inverse relationship with H pylori has been noticed. Our aim was to determine the association between EOE admission rate and various demographic factors and to compare it with H pylori admission rate. Methods: Nationwide Inpatient Sample (NIS) 2009-2014 was used. EOE admissions were identified by the presence of a primary diagnosis of EOE, or primary diagnosis of symptoms related to EOE (food bolus, dysphagia) and secondary diagnosis of EOE. Additionally, all the cases had upper endoscopy performed during the same admission. We used the year 2009 to identify H pylori admissions as comparison group. Admissions with diagnosis of gastritis/duodenitis/ulcer and diagnosis of H pylori infection and had upper endoscopy performed during the same admission were included to the H pylori group. Rates of EOE and H pylori related admission by age, gender, race, and income level were calculated. NIS database provides six-level urban-rural classification specifically designed for healthcare research purposes. EOE admission rate was calculated based on degree of urbanization. We used all-causes admissions as denominator. Rates were compared using Fisher Exact test. Results: We included 5,007 EOE and 29,006 H pylori related admissions. For EOE related admissions, median age 30 years with 65% men and 71% Caucasian. Overall EOE admission rate was 2.3 per 100,000 admissions. EOE admission rate were highest among <18-year-old (5.2), males (3.5), Caucasians (2.7), and highest quartile of the income (3.3) per 100,000 admissions (p<0.05, Figure 1). An opposite trend was observed regarding H pylori admissions. The rate was highest among older patients (106), Asians (180), and African Americans (135) and the lowest income quartile (87) per 100,000 admissions (p<0.05, Figure 2). The highest EOE admission rate was observed in the most urban areas 2.7 per 100,000 as compared to the lower urbanization categories (p<0.05, Figure 3).340_A Figure 1 No Caption available.340_B Figure 2 No Caption available.340_C Figure 3 No Caption available.Conclusion: In this nationwide analysis, EOE admissions were higher among young Caucasians from higher income levels in more urban areas. An opposite trend was noticed for H pylori. This suggests an important role for the hygiene hypothesis in defining the risk of EOE. This is the first study showing a positive correlation between income level and urbanization with EOE.