Hydatid disease is a zoonotic infestation caused by Echinococcus granulosus, most commonly affecting the liver and lungs. Primary involvement of renal, retroperitoneal, adrenal, or rectovesical regions is extremely rare. This study presents four cases with unusual extrahepatic localizations. Patients included three males and one female, aged between 26 and 71 years. The main presenting symptoms were pain and palpable mass, while one case was incidentally detected. Imaging modalities (computed tomography, magnetic resonance imaging) were essential for diagnosis; serological tests were positive in three patients and negative in one due to marked calcification. Three cases underwent open surgery, while one case was treated laparoscopically. No recurrences were observed during a mean follow-up period of seven years. In conclusion, extrahepatic hydatid cysts are rare and diagnostically challenging. Negative serological results do not exclude the disease; radiological findings combined with a multidisciplinary approach are crucial for accurate diagnosis and effective management.