The gold standard modality of management of cystic echinococcosis remains surgery. Regardless of the increased interest in nonsurgical techniques. The study aims to compare laparoscopic versus open methods of the hydatid cyst of the liver regarding complication rate, postoperative hospital stays, and effectiveness. A prospective randomized study. One hundred two patients with liver hydatid cyst in which 60 patients fulfil study requirements. Those undergone either open surgical or laparoscopic

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... pproaches under cover of albendazole treatment. The data divided into two groups, group 1 (28), group2 (32), we collected demographic data, surgical approach types, and postoperative data. The overall of 102 patients with hydatid cyst of the liver was randomized,60 patients full the study requirements, 28 patients (46.67%) had a laparoscopic procedure, and 32 patients (53.33%) had an open method. The total number of liver hydatid cysts was 70, and the operative time means 77 min (range,60–120 min) in the laparoscopic group and 55 min (range, 40–110 min) in the open group which is significant (P-value 0.0267). The postoperative hospital stay means time was 32 hours (range, 1–3 days) in the group of the laparoscopic procedure and 52 hours (range,2– 5days) in the group of open type. The postoperative surgical complication was significantly less in the laparoscopic group than the open group (p-value 0.014). A Hydatid liver cyst can be managed either by open surgical or laparoscopic techniques with comparable results. Still, the laparoscopic approach is superior in less postoperative pain, hospital stay and time, but it is essential in choosing the suitable patients.