Objective: Hydatid cyst disease, endemic in Eastern region of Turkey,is a significant parasitic public health problem. In this study, pleuralcomplications of hydatid cysts were presented in 76 cases.Materials and Methods: In our study, of the 412 pulmonary hydatid cyst cases operated on between 2003 and 2011, 76 cases had rup- tured into the pleura for various reasons, and the different clinico- radiological presentations were evaluated retrospectively. The age distribution of the cases was between 7 and 56 years, and the mean age was 26.20±13.04. Results: The most frequent symptom due to pleural rupture in pa- tients was dyspnea (44 cases, 57.8%). Etiologically, iatrogenic perfo- ration was detected in four cases and thoracic trauma in nine cases (six car accidents and three falls from a height). An anthelmintic drug use history was found in three cases of ruptured pleura. Spontaneous perforation was detected in the other 60 (78.9%) cases. Two cases that were admitted to the emergency unit and were immediately admin- istered a tube thoracostomy developed tension pneumothorax. In addition, 21 cases had hydropneumothorax, 17 had pneumothorax, and 36 had pleurisy. Morbidity was observed in 30 cases (39.4%). At- electasis was the most frequent cause of morbidity in these patients (10 cases). The mean duration of hospitalization was determined to be 12.26±2.90 days. Conclusion: This disease can progress asymptomatically for a long time and can sometimes lead to life-threatening emergency situa- tions, such as tension pneumothorax. The delayed admission of a patient to a physician causes the disease to become more compli- cated and to increase the morbidity and mortality rates. Treatment of the disease is in the form of surgery. Possible parenchymal protec- tion should be applied in surgical treatment, and anatomic resection should not be performed unless necessary.