Introduction : About 75% of all hydatid cysts are located in the liver and they are singular. Hydatid Cysts involving both lobes of liver are also observed. If they have occupied more than 70 percent of liver parenchyma then there is no other option except liver transplant. Sometimes it is difficult to deal with the large hydatid cyst occupying the posterior segment of liver specially segment 7.

Methods : A 25 years old female patient had pain abdomen and fever off and on. Radio logical investigations revealed 4 large hydatid cysts two occupying each liver lobe. On the right side it was in the posterior segment 7 and other was adjacent to that cyst. Two hydatid cysts were present in segment 2 and 3. Echinococcus antibody test was positive. Laparoscopic view was limited so open surgery was planned. Right lobe of liver was mobilized. Germinal layer of cyst was removed and usual protocol of hypertonic saline was followed. Same was done on left lobe of liver.

Results : Recovery was uneven full and patient was discharge on third postoperative day.

Conclusions : Hydatid cysts commonly found in the liver. Mostly they are single but they may be multiple and many times extra hepatic as well. Those cysts which are single in liver and in the anterior segments of liver can be dealt easily while those which are in the posterior segments require special considerations. If cysts are not occupied in the whole of the liver, then best treatment is removal of the cysts with its standard protocols.