BACKGROUND Hydatidosis is a tapeworm infection caused by the larval stage of Echinococcus species. The organs most frequently affected are the liver and the lungs. Primary involvement of the skeleton is rare. The location of hydatid cysts in the tibia is seldom described in the medical literature, and its diagnosis is challenging and often presenting with a pathologic fracture simulating benign bone cystic lesion. METHODS We report a 53-year-old Tigrian woman who developed hydatid disease of the tibia. CONCLUSIONS The diagnosis of primary bone hydatid disease, especially tibial hydatidosis, is difficult and requires high index of suspicion. Hence, orthopedic surgeons should be aware of this disease. Moreover, it should be considered in preoperative differential diagnosis of destructive bone lesions especially in endemic areas.