Hydatid cyst is a helminth infection. The rupture of a hepatic hydatid cyst in inferior vena cava is a rare and lethal complication. Pulmonary embolism is the commonest manifestation. The diagnosis of hydatid cyst is made by histopathological or serological examination, and imaging may suggest the probability of hydatid cyst. Surgical treatment should be performed with caution and always under vascular control. We present two cases of hydatid cyst ruptured into the inferior vena cava. The patients also presented with dyspnea, hemoptysis, and intermittent cough at the time of admission. This presentation will be accompanied by a brief review of the literature. The radiological findings suggested the diagnosis. The first patient had a fatal hydatid pulmonary embolism and death occurred on the second day of hospitalization. The second patient refused surgery. These cases also exemplify the clinical and radiographic findings as well as the management of this complication.