Echinococcosis or hydatid disease is caused by larvae of Echinococcus. The hydatid disease is endemic in some Mediterranean countries, Middle East, South America, South Africa and Oceania. The liver is the most common site of infection followed by the lung in 10% to 30% of cases. Pleural involvement of hydatid disease can occur, and usually follows the rupture of a pulmonary or hepatic hydatid cyst in to the pleural space. When a patient presents with recurrent pneumothorax, zoonotic infections, especially hydatid disease of the lung, should always be considered alongside other common causes of recurrent pneumothorax.