Sixty-nine patients were operated on because of hydatid disease of the liver from 1960 to 1986. There were 32 male and 37 female patients, with a mean age of 38 years at operation (range, 13 to 76 years). Forty-two cysts were solitary, 20 multiple, and 7 bilateral; 45 were located in the left lobe. Radical surgical procedures were carried out in 45 patients and consisted of cystectomy in six, pericystectomy in 25, and hepatectomy in 14; a conservative approach was used in 11 (resection of prominent part, internal or external drainage). The remaining 13 patients underwent a combination of both techniques. There were no deaths. Postoperative morbidity was low and equally distributed whether surgery was radical or conservative. Local complications occurred in six patients (9%), and seven other patients (10%) had systemic disorders. Four patients required reoperation: two for hemostasis and two for persistent fistulae (one biliary and one bronchobiliary). Of the 42 patients available for follow-up (61%), four (9%) had recurrent disease. One had undergone a pericystectomy and three, conservative procedures, at the time of primary surgery. Our results support the view that excisional surgery is a safe and valid option for patients with hydatid liver disease.