Abstract
Isolated renal hydatid cysts are rare manifestations of cystic echinococcosis and often pose diagnostic and therapeutic challenges. We present a 40-year-old male with a large multivesicular cyst in the left kidney managed successfully with preoperative albendazole followed by nephron-sparing open cystectomy. Imaging revealed typical features, and histopathology confirmed Echinococcus granulosus. Surgical precautions minimized intraoperative spillage. This case highlights the importance of imaging in diagnosis and planning, and supports open nephron-sparing surgery with medical therapy as an effective approach for managing large renal hydatid cysts while preserving renal function.