The rupture of the pulmonary hydatid cyst is a serious clinical problem because it causes significant local and systemic symptoms. Also, cyst rupture is not rare, but it is one of the most frightening and severe complications of hydatid cysts in the lung. METHODS We report a 16-year-old male with a 15-x-15-cm cyst in the lower lobe of his left lung that had ruptured into the pleural space and bronchus, resulting in a fistula. The germinal layer was discovered within the fluid of the effusion inside the pleural cavity. The cyst was surgically excised and treated with albendazole. A three-month follow-up found the patient to be healthy and free of symptoms. The presented case highlights the importance of early detection and management of pulmonary hydatid cysts. The rupture of these cysts can lead to significant local and systemic symptoms, as well as the formation of fistulas. Echinococcus infection of the lung is relatively common, but hydatid cysts in general require special management due to their tendency to go undiagnosed until they are large and accompanied by cysts in other areas. The presented case highlights the importance of early detection and proper management of pulmonary hydatid cysts to prevent complications and ensure successful outcomes for patients. CONCLUSIONS Infection of the left lung with Echinococcus is generally common, but hydatid cysts, in general, need special management because they usually are not detected early, are large, incidentally discovered, and are accompanied by cysts in other areas.