This systematic review and meta-analysis aims to determine the pooled prevalence of primary antibiotic resistance of Helicobacter pylori to key antibiotics (Clarithromycin, Metronidazole, Amoxicillin, Tetracycline, and Levofloxacin) in Egypt. The findings will provide up-to-date, evidence-based data to inform national treatment guidelines and improve eradication success rates.