Objective: Usually, open surgery is the recommended treatment of hydatid cyst. We present a novel technique for the treatment of a retrovesical hydatid cyst using a transurethral transvesical approach. Material and methods: Mr. M. A. 57 years had a retrovesical hydatid cyst diagnosed by ultrasound, for irritative bladder symptoms (LUTS), confirmed by CT scan and serology test. He had received 800 mg daily of albendazole during 3 months prior to operation. Operative technique: under spinal anesthesia, cystoscopy was performed using a 20.8 Fr nephroscope. The cyst was punctured using 18-gauge 36 cm needle, passed through the nephroscope operating channel. A 20 % saline solution was used as a scolicidal agent. The tract was dilated using balloon dilation over a guide wire. Then, the nephroscope was introduced into the cyst, and the hydatid material was aspirated. The cystic cavity and the bladder were drained using respectively a 14 Fr Foley catheter and 18 Fr Foley catheter. Postoperatively, the cystic cavity was treated by instillation of iodine-povidone during 5 days. Results: endoscopic treatment of retrovesical hydatid cyst was possible in 40 min. no complication was noted postoperatively. The patient had an uneventful discharge and had continued albendazole chemotherapy during 3 months. At 3 months postoperatively, cystoscopy confirmed a complete healing of the communication between the bladder and the cystic cavity. After two years of follow-up with ultrasound and CT scan, the patient was free of symptoms with no evidence of residual or recurrent disease. Conclusion: This transurethral transvesical approach was effective for the treatment of a retrovesical hydatid cyst with lower morbidity than open surgery, and confirmed that the bladder can be used as a portal to NOTES with no complications.