Intracranial alveolar echinococcosis is an uncommon disease and difficult to treat. Three patients with central nervous system (CNS) involvement are reported, and the surgical treatment of the monomassive type is emphasized. The largest mass lesion reported, so far, in the literature (9.0 X 6.5 X 4.5 cm) was extirpated in one of our cases. Related problems are discussed in combination with the literature.