Dyspepsia encompasses a range of upper gastrointestinal symptoms and presents significant challenges in primary care. This comprehensive review outlines the current approach to diagnosing and managing dyspepsia, categorizing it into three subtypes: ulcer-like, dysmotility-like, and unspecified dyspepsia. Routine screening is not recommended in asymptomatic individuals; however, the presence of alarm features—especially in patients over 60 years or those with specific risk factors—warrants prompt evaluation with esophagogastroduodenoscopy (OEGD). Helicobacter pylori testing plays a central role in the diagnostic pathway. Available modalities include the urea breath test, stool antigen test, and serological testing—each with distinct advantages and limitations. Management follows a structured approach involving lifestyle modifications, pharmacologic treatment with proton pump inhibitors or H2 receptor antagonists, and H. pylori eradication therapy when indicated. This review underscores the importance of recognizing alarm symptoms, appropriately stratifying patients, and applying a systematic approach to ensure effective management of dyspepsia. It also outlines specific criteria for referral to specialist care.