Background: Perinephric abscess is a relatively common urological infection that occurs with greater frequency in immunocompromised patients. Less frequently, these originate from haematogenous seeding or contiguous spread from a non-urological organ. Non-pylori Helicobacter species are uncommon and fastidious pathogens but have been reported to cause abdominal abscesses, usually from a gastrointestinal or hepatobiliary source. Case presentation: A 30-year-old male presented to the emergency department with 3 days of lower back pain and fevers. The abscess was drained percutaneously and no organism was initially cultured. However, 16S rRNA sequencing of the microbiological sample demonstrated Helicobacter species. The abscess recurred and was unsuccessfully treated with open surgical drainage and repeated percutaneous drainage over a period of 7 months. Multiple CT images showed clear distinction between bowel and kidney/abscess. Ultimately, a nephrectomy was performed to control the infection. Conclusion: To the authors knowledge, this is the first described case of a perinephric abscess caused by Helicobacter species. Management in this cases was challenging due to patient factors including poorly controlled diabetes. The underlying source of infection was unclear in this case, however direct contiguous seeding from duodenum remains a possibility