Primary hydatid disease of the rib is very rare, even in endemic areas. We describe a patient who presented with recurrent costal hydatid disease that caused spinal cord compression and progressive paraparesis 7 years after the initial cyst removal surgery. In the first operation, cysts were removed but no bone was resected. To prevent recurrence of costal hydatid disease, we recommend wide bone resection in addition to extirpation of the cysts.