Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 7 3 2024 10 30 59 64 Reza Eslamian Division of Thoracic Surgery, Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Sam Moslemi Division of Endocrine Surgery, Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Amir Reza Fazeli Division of Colorectal Surgery, Department of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Sina A Sharghi Division of Endocrine Surgery, Emam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran 2024 10 17 Hydatid disease is mostly found in endemic areas such as middle east, particularly in patients with certain history of exposure. Signs and symptoms depend on the organ infected by the cysts, as hepatic cysts may cause abdominal pain and jaundice. Pulmonary hydatid cysts on the other hand, usually occur in the lower lobe of the right lung, and present with chest pain, cough, or shortness of breath. Rupture occurs in about one third of patients, releasing a highly antigenic fluid, which can result in anaphylaxis when ruptured into the bronchus. Alternatively, although not common, pulmonary hydatid cyst rupture may result in pleural effusion or rarely, pneumothorax. Our patient was a young man presented with pneumothorax resulted from a ruptured pulmonary hydatid cyst and concurrent extensive DVT. The cysts were completely resected, and underlying parenchyma was repaired through a posterolateral thoracotomy, while DVT was managed by anti-thrombotic therapy.   https://ajs.tums.ac.ir/index.php/ajs/article/view/281