Background: Echinococcosis is an endemic disease in the Neotropical region of the Americas caused by Echinococcus spp. Most of the cases come from the Amazon region, where a disease is popularly called “paca disease”, due to the population's habit of eating the meat of Cuniculus paca. Case Report: We report 72-year-old Indigenous male presents cirrhosis complications caused by echinococcosis since 2010 confirmed by serological examination (titer 1:2560) and inactive cysts in imaging methods. Conclusion: Inactive cysts in echinococcosis are a source of complications such as liver cirrhosis and spontaneous bacterial peritonitis.