Hydatid infestation of the lung can be primary or secondary. Cystic echinococcosis (CE) is regarded as endemic in Sub-Saharan Africa, however, for most countries only scarce data, if any, exist. This is a retrospective analysis of children below 13 years with lung hydatid cyst admitted in the paediatric surgical ward at NMAH (Nelson Mandela Academic Hospital) in Eastern Cape, South Africa. The study period was from September 2015 to September 2017. The variables studied were age, sex, imagen findings, cysts sizes, treatment and complications. Prevalence and behaviour of lung hydatic cyst in our children were found out. There were 12 children studied, 8 females and 4 males. The age ranges from 5 to 10 years. The 50% of the children were to 10 years. The left lung was more affected, 7 patients constituting 58.3%, bilateral disease was seen in 3 patients. Treatment was surgical: punction, aspiration, injection and reaspiration (PAIR), removal of germinal layer, and partial capitonnage on a drain tube in 8 children (67%). A pharmacological treatment was offered to 4 patients. There was rupture of a cyst into the pleural space before surgery. Postoperatively 7 children developed broncho-pleural fistula. There was no mortality in this study. Hydatid cyst of the lung was most frequent on the left side. The surgical treatment performed was PAIR mostly in cysts more than 6 cm or with complications. Conservative treatment is an option in some cases.