Background Hepatic hydatid disease caused by Echinococcus granulosus remains a significant surgical challenge worldwide, especially in endemic regions. Although open surgery has been the traditional standard for definitive management, advances in minimally invasive hepatobiliary techniques have introduced laparoscopic procedures as a safer, less morbid alternative. Despite this evolution, concerns persist regarding intraoperative spillage, anaphylaxis, and long-term recurrence, particularly in complex cysts. Objective To compare the operative safety, postoperative outcomes, and recurrence rates between laparoscopic and open surgical management of hepatic hydatid cysts, using standardized patient selection based on the World Health Organization–Informal Working Group on Echinococcosis (WHO-IWGE) classification. Methods This prospective comparative study was conducted at the Department of Hepatobiliary and Minimally Invasive Surgery, King’s College Hospital, London, between January 2022 and December 2024. Sixty patients with radiologically confirmed hepatic hydatid cysts (WHO-IWGE types CE1–CE3a) were enrolled and assigned to either laparoscopic (n = 30) or open (n = 30) surgery. All procedures followed standardized scolicidal precautions using 20% hypertonic saline and closed suction systems. Postoperative morbidity, pain (VAS at 24h), hospital stay, and recurrence (12-month follow-up) were compared using t-test and Chi-square analysis (P < 0.05). Results Baseline demographics and cyst characteristics were comparable between groups. Laparoscopic surgery resulted in significantly lower blood loss (110 ± 40 mL vs. 210 ± 60 mL; P < 0.001), reduced postoperative pain (VAS 3.2 ± 1.1 vs. 6.1 ± 1.3; P < 0.001), and shorter hospital stay (3.1 ± 0.9 vs. 7.2 ± 1.6 days; P < 0.001). Wound infection occurred in 3.3% of laparoscopic cases versus 20% in open cases (P = 0.048). Recurrence rates at 12 months were low and statistically similar (3.3% vs. 6.7%; P = 0.55). No mortality or major bile duct injury occurred. Multivariate regression identified open surgery (OR 3.14, 95% CI 1.08–9.12; P = 0.035) and cyst size >8 cm (OR 2.86, P = 0.047) as independent predictors of postoperative morbidity. Conclusion Laparoscopic management of hepatic hydatid cysts is a safe, effective, and patient-centered alternative to open surgery for WHO-IWGE stage CE1–CE3a cysts. It offers clear advantages in reduced morbidity, faster recovery, and comparable recurrence control when performed under strict anti-spillage precautions by experienced hepatobiliary surgeons. Integration of WHO-based staging, standardized scolicidal protocols, and structured laparoscopic training is recommended to optimize outcomes and broaden access to minimally invasive hydatid surgery across both endemic and non-endemic regions.