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Hydatid cyst disease of the spine is rare, and only a few are reported in the scientific literature. This infection is caused by the larvae of Echinococcus granulosus cestode. The presentation is usually late because the patient remains asymptomatic for a longer duration after the infection. The initial form of treatment is always surgical in a symptomatic patient for excision of the diseased tissue. A 35-year-old male presented in the outpatient department with a chief complaint of mid-back pain and intermittent history of fever following his back surgery for 4 years. The patient has taken presumptive treatment for tuberculosis before presenting it to us. Radiological investigations dictate the presence of hydatid cyst in the D4 vertebra. Intact cysts were excised with perioperative albendazole coverage. The patient was mobilized on postoperative day-1 with Taylor's brace, and the brace was continued for 6 weeks. The patient was followed up at regular intervals for 1 year, and no recurrence was found. Hydatid cyst disease in the spine is a rare disease but associated with high morbidity despite significant advances in diagnostic imaging techniques and surgical treatment. For a provisional diagnosis, magnetic resonance imaging is the investigation of choice. Surgical decompression is the main stray of treatment along with antihelminthic therapy. A close follow-up is required after the initial treatment to find the recurrence at the earliest.