Objective Exploring the innovative application of 3D visualization technology in assisting the design of surgical treatment plans for hepatic alveolar echinococcosis (HAE). Methods Fifty HAE patients who underwent preoperative examination with 3D visualization technology at the Affiliated Hospital of Qinghai University from January 2020 to March 2023 were enrolled to participate the research. The patient’s raw data was transmitted to a human 3D visualization virtual surgical system to process 3D visual reconstruction modeling for determining the whole liver volume, planned liver resection volume, the liver volume to be reserved, and the hydatid lesion volume, thereby,the residual liver ratio was calculated, and compared with what actually seen in the operation to evaluate the application value of 3D visualization technology for HAE. Another 50 patients with HAE who did not undergo 3D visualization technology during the same period were selected as the control group. The control group received 2D enhanced CT imaging and precise liver resection. Compare the general and perioperative data between the two groups were compared and the generalized estimating equation (GEE) model was used to analyze the influencing factors on patients’ postoperative prognosis. Results There was no statistically significant difference in general information such as age, gender, body mass index (BMI), resection site, lesion diameter, excised liver volume, remaining liver volume, as well as differences in CT features and MRI imaging data between two groups of patients (P > 0.05). Compared with the control group, the study group had shorter surgical time [(228.56 ± 29.47) min], pringle method total liver block time [(26.65 ± 4.78) min], less intraoperative blood loss [(435.14 ± 98.76) ml], shorter hospital stay [(15.27 ± 2.13) days], lower hospitalization costs [(4.58 ± 0.79) yuan], and higher satisfaction with doctor-patient communication (89.65 ± 9.23) (t = 3.856, 3.561, 6.069, 3.561, 5.400, 3.812; all P < 0.05). The reconstructed 3D model can be rotated, scaled, and translated, and can also hide or render semi-transparent structures such as liver parenchyma, veins, and arteries, providing a clear and intuitive understanding of the spatial relationships between important anatomical structures and lesions in the liver. The average volume of planned liver resection predicted by 3D visualization technology is 2 154.43 ml, the average volume of reserved liver is 1 203.27 ml, and the average residual liver ratio is 41.22%. The average volume of liver resection during the operation was 2 138.75 ml, and the average volume of remaining liver was 1 193.46 ml. There was no statistically significant difference (t = 1.135, P > 0.05) between the estimated and actual liver volumes obtained through 3D visualization reconstruction. The GEE analysis results showed that the invasion of hepatic Echinococcus multilocularis edge infiltration and 3D visualization reconstruction significantly affected the prognosis of patients (χ² = 7.890, 3.876; P < 0.05). Conclusion Three dimensional visualization technology can be used to develop a rational liver resection plan for HAE patients before surgery, improving the success rate of surgery and enhancing patients’ prognosis.