Percutaneous needle aspiration of hydatid cysts has long been discouraged because of potential complications, such as anaphylactic shock and the spread of daughter cysts. We used this procedure with successful results, however, in the treatment of a woman with a recurrent hepatic hydatid cyst. The cyst was drained percutaneously using radiologic imaging guidance and then lavaged through a catheter using silver nitrate and hypertonic saline solutions. One year after drainage, all liver function test results remain normal. Although surgical drainage is normally the treatment of choice for hepatic Echinococcus disease, percutaneous catheter drainage may be an alternative therapy for patients who cannot undergo surgery.