Hydatid cysts are most often located in the liver and lungs (55-90%), while their location in the adrenal gland is very rare (0.5%). We observed a patient with a hydatid cyst in the adrenal gland, the diagnosis of which was incidental during ultrasonography and computed tomography. The experience acquired in Sicily where hydatid disease is endemic makes serological tests unnecessary, also because they often require a lengthy waiting period and are expensive. The patient had undergone surgery for the treatment of hepatic hydatid cysts. The adrenal localization may be explained as a consequence of secondary dissemination via the blood stream. The cyst developed inside the gland and caused atrophy of the glandular tissue. The surgical treatment called for adrenalectomy as the adrenal gland was entirely occupied by the cyst.