This study reports the first cases of simultaneous echinococcosis and tuberculosis (TB) in China, identified through retrospective community survey data from Xiji County, Ningxia Hui Autonomous Region. Two patients, an 18-year-old male and a 36-year-old female, were found to have both conditions, with the male patient showing a positive response to albendazole treatment and the female patient having a less effective response. The study highlights the challenges in diagnosing these co-infections due to similar symptoms and the potential for immune modulation by chronic helminth infections, which can suppress the Th1 immune response and affect the efficacy of TB vaccines. Given the high prevalence of both diseases in the region, the authors recommend future combined TB/echinococcosis surveys to improve early diagnosis and treatment outcomes, ultimately reducing morbidity, mortality, and financial costs.This study reports the first cases of simultaneous echinococcosis and tuberculosis (TB) in China, identified through retrospective community survey data from Xiji County, Ningxia Hui Autonomous Region. Two patients, an 18-year-old male and a 36-year-old female, were found to have both conditions, with the male patient showing a positive response to albendazole treatment and the female patient having a less effective response. The study highlights the challenges in diagnosing these co-infections due to similar symptoms and the potential for immune modulation by chronic helminth infections, which can suppress the Th1 immune response and affect the efficacy of TB vaccines. Given the high prevalence of both diseases in the region, the authors recommend future combined TB/echinococcosis surveys to improve early diagnosis and treatment outcomes, ultimately reducing morbidity, mortality, and financial costs.