Hydatic echinococcosis is preferentially localized to the liver. Primary bone localization is rare, characterized by high clinical latency, lack of radiological specificity and difficulties of its surgical treatment. We report the case of a 20-year-old young man with a hydatid cyst in the pelvis, diagnosed by a pain in his left hip and a lytic image of the ilio-pubic branch on X-ray. Treatment consisted on a resection of the cyst by both posterior and abdominal approaches, combined with antiparasitic treatment. The functional result was satisfactory, but the hydatid cyst recurred after 3 years, a medical treatment was considered using albendazole for one year. Currently at 12 years of follow up, the patient was asymptomatic and radiologically the hydatic cyst was stationary. The quality of the surgical resection is very important for the risk of recurrence. Pelvic localization of hydatid disease is particularly difficult to treat. Medical treatment using albendazol could be a reel alternative for the difficult cases not treated surgically.