Background <p>Liver hydatid cyst can be found anywhere in the world, but especially in endemic areas, including Iraq. However, its epidemiology and clinical patterns are different among various populations in other countries.</p> Objective <p>To find out the epidemiological and clinical profile of patients with liver hydatid cyst in our locality (endemic area).</p> Patients and methods <p>This observational cross-sectional study was conducted on a total of 250 patients diagnosed with liver hydatid cysts at multiple hospitals, Sulaimaniyah, Iraq, from January 2022 to March 2025. All patients underwent partial cystectomy for liver hydatid cyst under general anesthesia. A self-created questionnaire was used to collect patients’ data on their sociodemographic characteristics, environmental factors, risk factors, and the recurrence of liver hydatid cyst. Then, correlations between some variables were determined and compared.</p> Results <p>The mean age of the patients was 39.49 ± 17.97 years. Majority of the patients were aged &lt; 30 years (33.2%), females (60.4%), lived in rural areas (60.8%), had direct contact with livestock (55.2%) and dogs (59.2%), used spring water as their primary water source (56.8%), and did not have any family members diagnosed with hydatid cyst (92%). Among patients, only 19.6% experienced a postoperative bile leak that was significantly associated with cyst size (≥ 6&#xa0;mm) (<i>p</i> = 0.004) and multiple cyst (<i>p</i> &lt; 0.001) after adjustment of the data. More profound symptoms among patients was right upper quadrant pain (68.8%), while some individuals had jaundice, nausea and vomiting. Also, most patients (95.2%) did not experience any recurrence.</p> Conclusions <p>Postoperative bile leak was significantly associated with cyst size, number of cysts, and affected liver segment. Hospital stay was longer among patients with postoperative bile leak.</p>