Cystic echinococcosis, caused by the larval stage of Echinoccocus granulosus, is a global public health threat. The aim of this study was to determine the demographic and clinical characteristics of cases of primary and secondary hydatid cyst in the west of the Islamic Republic of Iran. A retrospective record review was made in 7 public and private hospitals in Kermanshah from 2004 to 2009. Of 526 files of suspected cases analysed, 291 cases of hydatid cyst had been operated upon and confirmed. Of the patients, 51.5% were females, 57.7% lived in urban and suburban areas and the largest age group (17.5%) was 31–40 years. The major organs involved were liver (64.9%) and lung (26.8%) and 18 cases (6.2%) were confirmed as secondary hydatidosis. Most patients (79.4%) had been treated with albendazole. Kermanshah province should be considered an endemic region for human hydatid cyst disease; greater efforts in prevention are needed.