Sixty patients who underwent operation between 1979-1987 for bilateral pulmonary hydatid disease using median sternotomy approach are reported on. Although some authors prefer two-stage thoracotomy and operate on the side with the larger cyst first, or perform simultaneous bilateral thoracotomies, we have preferred one-stage operation via median sternotomy. There were 29 female and 31 male patients, ranging in age from 5 to 55 years (mean 26.4 +/- 6.3). A total of 173 cysts were operated in 120 lungs. The usual operative technique was cystotomy and capitonnage. Operative and postoperative courses were uneventful in all but three cases (5%). The causes of mortality in these patients were excessive hemorrhage, mediastinitis, and septic shock respectively. It is concluded that median sternotomy is a better alternative method for the treatment of bilateral hydatid disease of the lung, as the duration of hospitalisation is shorter, the approach is better tolerated by the patients than thoracotomy, and it possibly prevents a second general anesthesia.