Echinococcosis is endemic in pastoral regions of south, west and mid-Gansu province, China. The present study aimed to determine the prevalence of echinococcosis in east Gansu, and analyze its associated risk factors. A cross-sectional survey was conducted in 2011 in 12 villages of Xiaonangou township, Huan County in east Gansu province by ultrasound abdominal scan and auxiliary serotest, and a prevalence surveillance study from 2008 to 2014 was performed in one villages by ultrasonography screening. Questionnaire information analysis indicates that the risk factors are in association with the gender, age, and education level. The cross-sectional survey found a cystic echinococcosis prevalence of 2.21% (107/4837). Higher prevalence was seen in females (χ2 = 4.198, P < 0.05), older ages (> 60 years) (χ2trend = 96.30, P < 0.05), and illiterates (χ2 = 90.101, P < 0.05). Prevalence surveillance showed changing profile of 3.35% in 2011 to 0.88% (1/113) in 2014.