Hydatid disease is a relatively uncommon finding in children characterized by cystic lesions mostly occurring in liver and lungs, while childhood asthma is one of the most common disorders in pediatrics. In patients with childhood asthma, other diagnoses should be considered and excluded. While the former is curable by an appropriate surgical approach, management of the latter is guided by clinical symptoms and response to therapy. Therefore, timely management of the hydatid disease is valuable in reducing the morbidity. The aim of this case presentation is to demonstrate the value of performing at least one chest x ray in children with asthma features in order to exclude other probable diagnoses. This study reports a 2.5-year old boy with a lung hydatid cyst erroneously being treated as asthma for more than a year. The puzzling signs and symptoms mimicking asthma and the presence of asthma in his father’s medical history led to the false assurance of the treating physicians of their diagnosis and therefore ignoring the need for obtaining a chest x ray in order to exclude other possible etiologies. Later, the persistent lack of response to asthma therapy raised the need for further evaluations including chest x ray which was strongly indicative of pulmonary hydatid disease. To conclude, patients with symptoms akin to asthma in endemic places for hydatid disease should be further evaluated for organic pulmonary diseases by imaging techniques, of which, chest x ray has a significant role as the initial diagnostic procedure.