Background: In this study, we present cases with pulmonary alveolar echinococcosis who were treated in our clinic.Methods: This single- center, retrospective study included 12 patients (6 males, 6 females; mean age 49.2 years; range 25 to 68 years) diagnosed with pulmonary alveolar echinococcosis between January 2008 and May 2015. Data including age and gender of the patients, the location, number, and size of the cyst, and spread to other organs outside the lungs were recorded.Results: Of the patients, eight had bilateral diffuse metastatic lesions, while the others had solitary or a few pulmonary lesions. One patient had an endobronchial lesion in the right lower lobe, one had a cystic lesion in the right lung and three lesions in the left lung, one had pulmonary invasion through neighborhood, and one had an endobronchial lesion in the right lower lobe. Initially, wedge resection was applied to the patient who had a solitary pulmonary nodule in the right lung and, then, liver transplantation was performed. Liver transplantation, wedge resection of the lung, and diaphragm resection/reconstruction were simultaneously applied in the patient who had pulmonary invasion through neighborhood. Bilateral thoracoscopic wedge resection with one-month interval was applied in the patient with cystic lesions, one in the right and three in the left lung, and liver resection was planned. Recurrence was not observed in any patients operated.Conclusion: Surgical treatment can be applied on carefully selected patients with pulmonary alveolar echinococcosis. The decision of surgery should be assessed according to the diffusivity of the lesion, liver functions, and general condition of the patient.