Cystic echinococcosis (CE) is a zoonotic infection caused by the tapeworm of the genus Echinococcus, a cestode endemic in many parts of the world. CE can affect any organ, with the lung being the second most commonly affected organ after the liver. For the management of pulmonary CE, guidelines recommend surgical resection of cysts with adjuvant anti-helminthic therapy. In cases where surgery is not possible, medical therapy alone can be used. However, to date, there is a paucity of data to advocate for one modality over the other. Here, we report two cases of pulmonary CE caused by E. granulosus, one was managed with surgery and adjuvant anti-helminthic therapy while the other was managed with medical therapy alone. Both patients had clinical and radiological resolution outlining the role and efficacy of both modalities of therapy.