Introduction: The rupture of the hydatid liver cyst in the pericardium is a very exceptional and serious complication that can cause sudden death following cardiac tamponade or anaphylactic shock.
Case Presentation: We report a case of a 25 years-old woman with a massive pericardial effusion due to fistulization of hepatic hydatid cyst. Surgical closure of the fistula and the resection of the tow hydatid cysts were successful in managing this rare case.