We report, a very unusual case of multilevel vertebral hydatidosis adjacent to the thoracolumbar junction, without concomitant chord compression. Two months after initiating oral antiparasite treatment, the patient underwent resection of the lesion using a posterior approach, medullary decompression, and a T11–L3 instrumented arthrodesis. Arthrodesis via the anterior approach was performed at a later stage. In addition to its diagnostic value, this case raises renewed discussion about single-level lesions given their rarity: their indication for preoperative medullary angiography, their indication for circumferential surgery, the timing of medical treatment, and the strategy to implement for the residual lesions.