Adrenal gland has been considered as an atypical localization of Echinococcus Granulosus and the reported incidence is 0.5%. We report a rare case of coexistence of primary adrenal hydatid cyst and arterial hypertension. The patient underwent surgical excision of the adrenal gland with a slight improvement of blood pressure's regulation, requiring antihypertensive medication postoperatively. Till today, two cases of coexistence of primary adrenal hydatid cyst and arterial hypertension have been reported in the literature. However there is not clear and acceptable explanation about the relation and the involved pathogenetic mechanism. Resection of the cyst with conservation of the gland remains the optimal procedure. In case of haemorrhage or failure to perform a cystectomy, ablation of the entire adrenal gland including the cyst should be performed.