Gastric adenocarcinoma has been considered as an infectious disease since 1994, when the Helicobacter pylori [H. pylori] infection categorized as a definite class I human carcinogen. H. pylori uses extensive numbers of virulence factors to overcome host defence mechanisms. One independent H. pylori factor that plays an important role in determining H. pylori pathogenesis is vacuolating cytotoxin A [vacA] . The purpose of this study was to investigate the frequency of vacA Genotypes, and also its association with disease outcome in infected patients. Antral gastric biopsy materials were collected from 88 patients with different gastroduodenal diseases. Genotyping of the VacA alleles were determined by PCR methods. Of 64 H. pylori positive patients, 38 were classified as gastritis, 11 as peptic ulcer, and 15 as gastric adenocarcinoma. Four Vac A genotypes were observed, including 20 [22.7%] for s1/m2 [with frequency of relatively equal in all groups] , 12 [13.6%] for s1m1 [with the highest frequency in gastric adenocarcinoma and peptic ulcer] , 7 [7.95%] for s2m2 [with the highest frequency in gastritis] and 3 [3.4%] for s2m1 [with the highest frequency in peptic ulcer] . In this study, no significant relationship was observed between the different genotypes of the vacA and the clinical outcome. Gastric adenocarcinoma also showed significant association with age and gender