Hydatid disease has a wide geographic distribution and is considered an important global public health problem which is influenced by the socioeconomic status of the population. Migration also spreads this disease. The state of Kashmir, India, is endemic for hydatid disease. In endemic areas, any patient presenting with a cystic mass, in any tissue or organ, should be considered a potential case of hydatid disease. Human echinococcosis is caused by infection with the larval stage of genus Echinococcus granulosus and Echinococcus multilocularis. Primary hydatid cyst in the pelvis is an extremely rare site of the disease [1]. Only 0.2–0.9% of all echinococcal cysts have been reported in the female pelvis, with most located in the ovary, parametrium, or adnexa and occasionally in the omentum with adherence to the pelvic organs [2, 3]. Primary pelvic echinococcosis is exceptional even in endemic countries; it generates significant diagnostic difficulties as the symptoms are non-specific (Fig. 1).