Since 1976, 14 patients with hydatic disease of the lung and chest wall underwent surgery at the Ruhrlandklinik Essen-Heidhausen. In two of them primary intra- and extra-osseous echinococcosis of the rib was seen. The patients came from Mediterranean countries, and the clinical symptoms were not very marked. The diagnosis is usually based on a routine chest film, chest tomography, and computerized axial tomography. The specific parasitological laboratory tests are seldom positive. The "gold standard" for therapy is radical removal of the ribs or chest wall involved.