Seventy-one-year-old man had a liver mass. He lived in Hokkaido, where there is an epidemic of hydatic disease. Abdominal US image showed an echogenic mass. CT revealed a low density mass with an unclear margin. A 99mTc-Sulfur colloid liver SPECT study was performed to detect the liver mass. The SPECT scan was done after intravenous administration of 5 mCi of 99mTc-sulfur colloid, and it revealed a lack of uptake in the liver mass. The liver SPECT findings were correlated with subsequent CT and US imaging. Echo-guided biopsy showed a PAS-positive cuticle layer of echinococcosis in the necrotic tissue. This is the first report of a case of detection of hepatic alveolar echinococcosis by means of a colloid liver SPECT imaging procedure.