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Echinococcosis, often referred to as hydatid disease, is caused by an infection with the tapeworm Echinococcus. Cystic hydatidosis is known to be a significant public health problem in certain regions, however the worldwide prevalence is underestimated and in the UK, hyadtidosis is uncommon. We present an unusual case of alveolar echinococcus during pregnancy.The patient, a 36 year-old female, originally from Iran presented at 8 weeks pregnant with right-sided chest pain and shortness of breath. A CXR revealed a solitary fluid-filled cavity in the right upper lobe, and although serology was negative, she was diagnosed with Alveolar Echinococcus based on imaging and likely exposure to the organism responsible. Cystic hydatidosis is typically asymptomatic in its early stages however the symptoms experienced by our patient are classically seen with acute cystic rupture and therefore after discussion with infectious disease colleagues the patient was managed conservatively with a combination of albendazole and praziquantel. She was monitored regularly throughout pregnancy by both Infectious Disease and Obstetric teams. Her symptoms improved, as did the radiological appearance of the cyst. She subsequently had an uncomplicated vaginal delivery at 41 weeks and is now awaiting surgical management of the cyst.This case highlights the importance of remaining vigilant during the diagnostic process, the management difficulties presented in pregnancy and finally, the benefits of shared patient care.