The  OBJECTIVE  of the  study  is  to  evaluate the  approaches of surgical  treatment of complicated forms  of liver echinococcosis. MATERIAL AND METHODS.  During  the  period  from 2010  to  2016,  surgical  treatment of liver echinococcosis was  performed in 202  patients, 161  patients of them  (79.7  %)  had  primary  echinococcosis, and  41  patients (20.3  %) had  recurrent echinococcosis. The  work is based on the  retrospective analysis of the  results of preoperative examination, intraoperative  ultrasound  examination  and   treatment of  46  (22.8  %)  patients with  complicated echinococcosis  –  with isolated liver damage or  in combination with other  localizations. 8  patients had  concomitant  complications.  RESULTS. Cyst  suppuration is the  most  common among the  complicated forms  of liver echinococcosis. CONCLUSION.  Complicated liver echinococcosis should   be  operated in the  specialized institution  with modern diagnostic and  treatment equipment and  highly  qualified  specialists.