We report the case of a 33-year-old woman who was admitted to our clinic with the diagnosis of chronic arterial occlusion of the right lower extremity. Preoperative angiography suggested an iliofemoral atherosclerotic occlusion. During surgery multiple hydatid cysts causing iliofemoral occlusion were found and excised. Arterial reconstruction was performed using an iliofemoral bypass technique with a polytetrafluoroethylene vascular graft. This case emphasizes that, in sheep-raising countries or in patients from such countries, primary vascular echinococcosis should be considered in the differential diagnosis of chronic arterial occlusion.