The aim of this study was to determine the efficacy and success of the percutaneous modified catheterisation technique (MoCaT) in the treatment of type 2 and 3b liver hydatid cysts. A total of 21 patients (13 female, 8 male) aged 23 to 78 years (median: 35) with 25 cysts were included. All cysts were catheterised (12-16 F) under imaging guidance. Daughter vesicles and membranes were destroyed by manipulation of catheter and wire. Repeated injection and reaspiration with small volumes (5-10 ml) of hypertonic or isotonic saline. Daughter vesicles, endocysts and non-drainable material were aspirated. 17 of 25 hydatid cysts (68%) were associated with the biliary system, 8 hydatid cysts were not. The procedure was terminated by withdrawal of the catheter after development of cyst collapse, aspiration of all material. The median duration of catheterisation was 60 days (min:15, max:120) in the case of cystobiliary fistula and 5 days (min:4, max:10) without fistula (p<0.001). All patients were treated with 96% technical success (24 cysts). While volume reduction was 100% in 18 cysts, the median volume reduction in 7 cysts was 90% (min: 25%, max: 98%). Patients were followed up for a median of 18 months after treatment (min: 6, max: 42), with no recurrence in 96% of patients. Treatment of hepatic cystic echinococcosis type 2 and 3b with the MoCAT technique is an effective and safe treatment when performed under appropriate technical conditions. It has been shown to be helpful compared with surgical treatment in reducing hospitalisation and preventing complications.