Abstract: Objective To observe the application of enhanced recovery after surgery (ERAS) in complicated hepatic alveolar echinocoecosis surgery. Me thods We selected 117 patients from 2013 to 2016 and divided them into 3 groups in chronological order: Group A (n =35) , the traditional management group. All patients underwent perioperative management according to previous procedures. Group B (n=44) , the transitional management group. The management in the transition period was improved as far as possible in accordance with the ERAS programme. Group C (n=38) , the standard process group. All patients were treated in full accordance with standard process. The hemodynamics data, fluid volume and the perioperative complications were recorded in all groups. Re s ults Compared with group C, there was no significant difference in the general condition and the incidence of complications before operation, the anesthesia time, the operation time, blood loss, blood transfusion and the heart rate in group A and B. The incidence of hunger and thirst before operation, infusion volume, urine output, the incidence of postoperative complications and the average length of hospitalization were all higher than those in group C. The differences were statistically significant. Conclus ion The clinical path optimization of ERAS in liver hydatid surgery can significantly reduce the perioperative complications and reduce the average length of hospitalization.