Pulmonary hydatid disease is a helminthic zoonotic disease caused by Echinococcus infection. The symptoms may appear several years after infection. Chest computed tomography (CT) is the preferred examination method and plays an important role in early diagnosis, treatment, and prognosis evaluation. CT can be used to diagnose simple cystic lesions. However, when the cysts are infected or ruptured, atypical imaging findings such as increased cyst density, blurring of the cyst wall, and surrounding exudation may lead to misdiagnosis of lung infection or lung abscess, hindering the therapeutic effect. We analyzed and compared the atypical imaging manifestations of pulmonary simple hydatid disease and hydatid cyst rupture. The aims of this report are to improve clinicians' understanding of these diseases, promote early diagnosis and treatment, and reduce the occurrence of complications.