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Helicobacter pylori (Hp) is a gram-negative bacterium that mainly colonizes in human gastric mucosa and causes a long-term immune response.The mechanism of Hp transmission is still not completely understood up till now.The pathways of a person-to-person and food chain transmission were evidence-supported and might be the most probable pathways of Hp transmission.We hypothesize that Hp may also by transmitted via respiratory tract and the mechanism as follows.Step 1,the reflux fluids from stomach takes Hp to Esophagus and throat.Step 2,Hp colonize on upper respiratory tract by microaspiration.Step 3,Hp that colonized on respiratory tract are exhaled via droplets after expiratory events.Step 4,the droplets with Hp were inhaled by the susceptible persons and Hp may colonize on respiratory and digestive tract in order with the medium of reflux fluids.