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Liver echinococcosis is an endemic disease in some areas of the world like Middle East and is a serious problem both from social-economic and clinical-therapeutical stand-points in other areas like Mediterranean regions. We report our experience on hepatic echinococcosis diagnosis and treatment over a 20-year period. In this retrospective study we have reviewed 89 patients affected by hepatic hydatidosis who underwent surgery in our Unit (between November 1975 and October 1995). Patients were divided into two grou – ps: group A including 65 patients (30 males and 35 fema – les) operated on between 1975 and 1988 and group B including 24 patients (11 males and 13 females) operated on between 1989 and 1995. Main outcome measures reported were recurrence of echinococcosis, association with surgical procedure, complications, diagnostic trial.