Over the last decade substantial improvements have been made in the diagnosis and management of hydatid disease. New diagnostic tests, imaging procedures including ultrasonography, computerized tomography, magnetic resonance and ERCP. Until recently the only definitive treatment for hydatid disease has been surgery, which carries high morbidity, mortality and recurrence. Advances in drug therapy has been influenced by the introduction of Albendazole. In our own study, Albendazole was administered to 22 patients with hydatid disease of the liver, and encouraging results were achieved in most of the patients. Another recent improvement has been the introduction of a non-surgical endoscopic method for the management of biliary and liver echinococcus. In 1985 we published the first report on the use of this procedure. The fourth recent aspect of treatment is the percutaneous aspiration and drainage of hydatid cyst of the liver. These recent developments, used either alone or in combination, are, we believe, good potential alternatives to operative surgery that carry a smaller incidence of complications, morbidity and mortality.