Hydatid disease is caused by Echinococcus granulosus. Hydatid cysts are commonly located in the liver and lungs. The occurrence of pancre-atic hydatid cysts is very rare, even in endemic areas. Sinistral portal hypertension, which is rarely seen, occurs when a pathological processcauses splenic vein occlusion. A 26-year-old male patient presented with abdominal pain. He had a history of operation for hydatid cyst ofthe lung 15 years ago. A left thoracotomy incision scar was observed during his physical examination. Laboratory findings revealed no ab-normalities. Abdominal ultrasonography revealed a 96×69-mm lobular, contoured, well-circumscribed cystic lesion with thickened septation.Abdominal magnetic resonance imaging revealed a 100×76-mm smooth, bordered cystic lesion containing septations in the body and tailof the pancreas compressing the splenic artery and vein, causing sinistral portal hypertension. Dilatation was noted in the left gastroepiploicvein. The patient underwent cystotomy. Pancreatic fistula developed during the postoperative follow-up. The patient was discharged in 20days without postoperative complications. No complications were observed during the follow-up period of 7 months. Surgery should beconsidered as a more conservative approach.