A primary posterior mediastinal hydatic cyst presenting with spinal compression syndrome is rare. We describe the case of a 35-year-old lady with a posterior mediastinal hydatid cyst who presented with progressive paraplegia. Excision of cyst was followed by systemic Albendazole therapy. She showed neurological recovery without recurrence till now. The role of Albendazole in preventing recurrence has been stressed and the relevant literature has been reviewed.