Background <p>There is a lack of data on the effects of family-based <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection control and management (FBCM) strategies in Southwest China. This study aimed to evaluate the two-year outcomes of these strategies in affected households.</p> Methods <p>Individuals who participated in a two-year <i>H. pylori</i> survey in Chongqing (China) were included in the study. Households where all <i>H. pylori</i>-infected members underwent eradication treatment were classified as group A, while those that did not follow whole family eradication therapy were designated as group B. The eradication rate, incidence of new infections, and changes in hygiene and living habits, were compared between the two groups.</p> Results <p>This study included 472 cases from 171 families, including 296 in group A and 176 in group B. The eradication rate in group A was significantly higher than that in group B (89.39% vs. 70.45%, <i>p</i> = 0.003). The compliance (87.88% vs. 84.09%, <i>p</i> = 0.519) and timely reexamination rates (46.97% vs. 31.82%, <i>p</i> = 0.063) were similar between the two groups. Among <i>H. pylori</i>-infected cases, the endoscopy uptake rate in group A was significantly higher than that in group B (30.30% vs. 13.98%, <i>p</i> = 0.004). Group A exhibited significant hygiene improvements after 2 years, including reduced raw water drinking (5.74% vs. 2.36%, <i>p</i> = 0.037), decreased shared cup usage (27.70% vs. 9.46%, <i>p</i> &lt; 0.001), and increased individual dining (6.08% vs. 16.22%, <i>p</i> &lt; 0.001). Group B showed decreased shared plate usage (26.14% vs. 5.11%, <i>p</i> &lt; 0.001) and increased plate disinfection rates (25.00% vs. 44.89%, <i>p</i> &lt; 0.001).</p> Conclusion <p>The FBCM strategy significantly improved <i>H. pylori</i> eradication rates and promoted healthier hygiene behaviors.</p>