Cardiac hydatid cysts are found mostly within myocardium. Only a few cases of pericardial location have been reported. Patients with hydatid cysts are usually asymptomatic. A 46-year-old man with clinical and electrocardiographic features mimicking acute myocardial ischemia was hospitalized for further evaluation. Detailed imaging and laboratory investigation revealed a pericardial hydatid cyst. The patient underwent operation for curative excision. After surgery the patient's symptoms resolved and his clinical status improved. We think that pericardial hydatid cyst should be considered in the differential diagnosis of patients with angina-like pain-especially in geographic areas where hydatid cysts are endemic.