Abstract: Abstract Objective. 82 cases malignant hepatic hydatid disease during the last 10 years were reviewed. Methods. 82 patients were divided to 3 stages with their PNM classification: 26 cases in the early stage with P0-2N0M0, 39 cases in the intermediate stage with P3-4N0-1M0-1, P0-2N1M0 and P0-2N0M1, 17 cases in the late stage with P3-4N1M1. 36 cases from the early and intermediate stage groups accepted the radical surgery treatment, 28 cases from the intermediate and late stages got the palliative surgical treatment, the other 19 cases in the late stage gained chemotherapy. Their efficacies were analyzed and accessed. Results: During 3-5 years of follow-up study, 1 case died three years later, 2 cases distant metastasis after four years and 2 cases with local recurrence were clinical cure with further chemotherapy in 36 cases with radical resection. Meanwhile, 2 cases died in 2nd year, 5 cases died in 3rd year, 2 cases with distant metastasis in 4th year, other postoperative complications such as the residual cavity infection 11 cases, biliary fistula 9 cases and liver failure 13 cases in 28 cases with palliative surgery. Survival cases were recovered well undergoing chemotherapy and comprehensive treatment, including 2 cases had a second radical surgery in 2nd year. In 19 cases underwent chemotherapy and treatment, 4 cases were given surgical drainage due to the abroad liquescence lesion and infection, 1 case was clinically cured with radical surgery after two years chemotherapy.Conclusions: Radical resection combined with chemotherapy could bring clinical curability for the early, early to intermediate stage cases. For the patients in the intermediate to late stages, chemotherapy treatment was the first choice, and then the radical surgery or liver transplantation surgery could be considered after they were in stable condition or lesions smaller or improved. For the patients with multi-organ metastasis, chemotherapy was the first choice, and then the possible surgical treatment for the life-threatening alveolar echinococcosis lesions, furthermore with following chemotherapy.