This study aims to research Primary hydatid disease of the spine. Hydatid disease or hydatidosis caused by Echinococcus granulosus is the most widespread, severe human cestode infection globally. Bone involvement is reported in 0.5 – 4%, with spinal participation reported in 50% of these cases. We report a case of this rare entity of an isolated primary hydatid cyst of the spine in a 15-year-old boy, who presented with progressive back pain for eight months, lower extremity weakness, and urinary incontinence for three months. Neurological examination suggests upper motor neuron type of paraparesis grade 1/5 with complete sensory loss below T4 level. 

MRI of the spine showed multiple cystic extradural lesions at the T4 – 5 level with the involvement of paraspinal muscles involvement. The patient underwent a T4 – 5 laminectomy and  total excision of the multiple epidural and paraspinal cysts. The diagnosis of hydatid disease was confirmed by the doctors on histopathology. Albendazole was started postoperatively. At six months follow-up, the boy had no neurological deficit, was playful, active, and walking. Postoperative MRI at six months showed no recurrence of the lesion. Analysis of the other reported cases is discussed with relevance to our case.