We report the peculiar case of a young woman with hepatic hydatid cysts, with numerous peritoneal disseminations (56 cysts) incidentally diagnosed during a caesarian section. The case was managed, surgically preceded and followed by systemic treatment with albendazole. Surgical treatment addressed both the hepatic cyst and the peritoneal hydatid disease aiming to preserve involved abdominal organs. The diagnosis of peritoneal hydatid disease is today more accurate due to the new imaging techniques and the surgical procedure should be tailored to each patient depending on size, location and complications of each cyst. Radical treatment is the best and represents a goal, but with multiple disease, a staged treatment and special care for organ preservation should prevail as recurrences are not unusual.