ABSTRACT: BACKGROUND: Echinococcosis rates vary in different parts of the world. Italy is regarded as a middle to high risk country with over 1,000 cases requiring surgery each year. Liver (45-75%) and lung (10-50%) are the most frequent locations of this parasitosis. CASE PRESENTATION: The authors report a clinical case of a 62 year old woman, admitted to hospital with left flank pain. Plain radiographs of the abdomen, ultrasound, CT and MRI scans were performed and the presence of a 3-cm lesion of the left adrenal gland was demonstrated. A diagnosis of hydatid cyst was made. The patient underwent transabdominal laparoscopic left adrenalectomy. Histopathological examination confirmed the presence of a hydatid cyst in the left adrenal gland. CONCLUSION: A hydatid cyst was correctly diagnosed on the basis of radiologic findings. The uncomplicated cyst was successfully resected using a laparoscopic approach. The pathological features of this case are presented in this paper.