During the last 20 years (1972-1992), 421 patients underwent surgery for hydatid disease of the liver. 96 out of 421 patients had a rupture such as, intrabiliary rupture 49 patients, intrathoracic rupture 43 patients and free rupture in the peritoneal cavity 4 patients. The surgical treatment required a variety of procedures: 1) Prolonged tube drainage of the residual cavity and exploration of the common bile duct followed by either T tube drainage or sphincteroplasty or choledocho-duedonostomy if it was necessary, for intrabiliary rupture. 2) Lung resection if it was necessary, and evacuation plus drainage and the hepatic cavity followed by suture of the diaphragmatic rupture of closure of the bronchial opening if present for intrathoracic rupture. 3) Lavage and prolonged tube drainage of the hepatic cavity for free rupture in the peritoneal cavity. Five patients died in the postoperative period one from suppurative cholagitis, one from pulmonary embolism and 3 from M.O.F.