Alveolar echinococcosis (AE) is a parasitic infestation produced by Echinococcus multilocularis. The parasite is a rare human infestation with a wide geographic distribution. It primarily affects the liver, and may spread hematogenously to produce metastatic foci in the distant organs. AE can metastise to the lungs, brain and bones. Cerebral involvement is rare but may be lethal. Cerebral AE is a rare but life-threatening parasitic disease. Here we report a 52-year-old man with cerebellar involvement of Echinococcus multilocularis.