Echinococcosis or Hydatid disease is a zoonotic parasitic disease, endemic in certain regions of the world like Mediterranean, Mid East, South America, Australia, South Asia including India. Canines are the definitive hosts and sheep, goat, cattle are the intermediate hosts. Man is an accidental host with no role in the transmission. Route of transmission is feco-oral, most often from soil or water contaminated by dog feces. Cyst is the larval stage of the parasite that develops in man. Liver is the most common site of these cysts and the infestation is usually caused by Echinococcus granulosus. Spleen is rarely involved, more so when it’s an isolated site of involvement, accounting for nearly 4% of abdominal hydatid cysts.1,2,3,4,5 Primary splenic hydatid cyst is thought to result either from arterial seeding bypassing liver and lungs or via possible venous reflux through the portal vein. Secondary splenic hydatid cysts result from systemic dissemination or following intraperitoneal rupture of liver hydatid cysts.6,7 Splenic hydatid cysts may be asymptomatic, detected incidentally8 or may present with vague abdominal pain, early satiety, dyspepsia, dyspnoea due to pushing up of the diaphragm9, constipation, local compressive symptoms or as a mass10,11,12. Splenic hydatid cyst may present acutely with rupture, which is most commonly due to trauma and less frequently spontaneous.13 Rupture can be into neighbouring viscera like colon14 or into the pleural or peritoneal cavity. Free intraperitoneal rupture can lead to anaphylaxis that can be potentially fatal.15,16 Intraperitoneal rupture can present with clinical features ranging from vague abdominal pain to frank peritonitis with typical signs. Intraperitoneal rupture of splenic hydatid cyst is exceedingly rare. 17,18,19 Although hydatid disease is found in pregnancy with an incidence of 1 in 20000 to 1 in 3000020,21 but liver is the usual site of involvement in pregnancy as well. Splenic cysts in pregnancy are extremely rare.22 Most splenic cysts in endemic areas are hydatid cysts.23 There are very few reports of hydatid cyst of spleen in pregnancy.24,25 Pregnancy increases the risk of rupture owing to raised intra-abdominal pressure. There is a scant account of spontaneous rupture of hepatic hydatid cysts during pregnancy. However, there is hardly any literature documenting spontaneous rupture in the postpartum period. Ante natal detection should be accompanied by meticulous planning and follow up so as to prevent potentially fatal complication like rupture or haemorrhage. Differential diagnoses include epidermoid, pseudocyst, abscess, haemorrhage, neoplasm. USG and CT are the main stay of diagnosis especially in acute settings to rule out other causes of acute abdomen, with CT being superior.26,27,28 The characteristic appearance varies as per duration, location, presence of secondary infection or rupture. Serological tests like ELISA, Immunoelectrophoresis, or Indirect Hemagglutination test have limited feasibility in ruptured hydatid cyst, but nevertheless can be used when the diagnosis is in doubt. MRI has also been used in cases where USG/CT are inconclusive. Management of the ruptured cyst warrants an urgent laparotomy.19 Splenectomy is the treatment of choice particularly in ruptured cysts.29,30 Owing to post splenectomy complications including sepsis related deaths in 1.9% of adults and 4% of children, a number of spleen preserving procedures have come up.31 There appears to be no significant difference between the rates of recurrence following splenectomy and spleen preserving procedures.32,33 Despite this the most feasible option in a ruptured hydatid cyst of spleen continues to be splenectomy. Even though the optimal management of splenic cysts in pregnancy is yet to be established, but the management in postpartum period especially in case of rupture is straightforward.22 A thorough lavage followed by scolicidal irrigation is necessitated to minimize seeding and recurrence. Various scolicidal agents like cetrimide, povidone iodine, hypertonic saline, chlorhexidine can be used. Laparoscopic procedures have been done in splenic hydatid cyst but in elective, uncomplicated cases. 34,35 Laparoscopic approach on emergent basis in case of a ruptured cyst remains largely unattempted. Preoperative medical treatment with albendazole is not possible in patients who present with ruptured cysts, but should be started postoperatively as soon as possible. Patients should be followed up with USG and serological tests at shorter intervals.