Background: To explore the correlation between ultrasound classification of liver hydatid disease and pelvic hydatid disease in the Tibet region. Methods: A retrospective analysis was conducted on the clinical and ultrasound examination data of 23 patients with co-occurring hepatic and pelvic echinococcosis admitted to the People's Hospital of Tibet Autonomous Region. All cases were confirmed by surgical pathology or through both ultrasound and CT imaging examinations. The locations, sizes, and imaging characteristics of the hepatic and pelvic lesions were observed, and the WHO classification was applied to analyze the correlation between the ultrasound classification of hepatic and pelvic echinococcosis. Results: In a cohort of 23 patients with concurrent liver and pelvic cysticercosis, hepatic lesions were identified in the left lobe in 3 cases, the right lobe in 19 cases, and bilaterally in 1 case. With the exception of 2 lesions situated in the right posterior segment of the liver, all remaining 21 lesions were closely associated with the liver capsule. The ultrasonographic subtypes were: multivesicular type in 2 cases, ruptured lesions in the pelvic region were located in the abdomen and pelvis in 3 cases, the pelvis in 20 cases, including 3 cases in the left pelvis, 9 cases in the right pelvis, and 8 cases affecting the entire pelvis. The ultrasonographic subtypes for these pelvic lesions comprised: single cyst type in 1 case, multivesicular type in 10 cases, ruptured inner cyst type in 4 cases, solid type in 4 cases, and calcified type in 4 cases. Ultrasonography correctly diagnosed 14 cases (60.86%), was inconclusive in 8 cases (34.78%), and incorrectly diagnosed 1 case (4.34%). In all cases of concurrent pelvic cysticercosis, the ultrasonographic subtypes were lower or equal to those of concurrent liver cysticercosis, indicating a correlation between the two. （r=0.442，P<0.05） Conclusion: In the co-occurrence of liver and pelvic echinococcosis, pelvic echinococcosis lesions are mostly caused by implantation and metastasis of hepatic echinococcosis lesions, and there is a significant correlation between the ultrasound classification of the two.