Objective To analyze the cost-effectiveness of population screening and patient treatment for echinococcosis in Xizang from 2015 to 2022, so as to provide insights into formulation or adjustment of the echinococcosis control strategies and measures. Methods The costs for population echinococcosis screening and echinococcosis patient treatment, newly diagnosed echinococcosis cases, and treatment efficiency in Xizang from 2015 to 2022 were collected from the annual report system of the Hydatid Disease Prevention and Control Program in Xizang Autonomous Region, and the cost-effectiveness of echinococcosis screening and treatment was calculated in each year from 2015 to 2022 and in each prefecture/city. The incremental cost-effectiveness atio (ICER) was used to examine the association of the difference (∆E) between the actual disability-adjusted life years (DALYs) due to echinococcosis and the estimated DALYs without interventions with the total costs of echinococcosis screening and treatment (∆C) in Xizang, and the willingness-to-pay (WTP) threshold was measured as a ratio of ICER to per capita gross domestic product (GDP). The difference in the overall response to treatment was tested for statistical significance with Kruskal-Wallis (K-W) test among years, followed by pairwise comparisons with Bonferroni corrections. Results The total costs of population screening for echinococcosis were 54.171 million yuan in Xizang from 2015 to 2022, with the highest in 2017 (27.624 million yuan). The cost-effectiveness ratio for screening newly detected echinococcosis cases appeared a tendency towards a rise over years from 2017 to 2022, from 1 641 yuan/person in 2017 to 21 131 yuan/person in 2022. The proportion of newly detected echinococcosis cases by screening was highest in Shigatse City (0.10%) and lowest in Shannan City (0.00%) in 2022, and the cost-effectiveness ratios were 10 000 yuan/person and 209 000 yuan/person, respectively. The total costs for echinococcosis patient treatment were 80.560 million yuan in Xizang from 2015 to 2022, peaking in 2018 (39.055 million yuan), including 58.807 million yuan for surgical treatment (73.0%) and 21.754 million yuan for drug treatment (27.0%). The overall cure rate of echinococcosis patients was 11.1% in Xizang from 2015 to 2022, with no significant annual trends in cure rates; however, the proportion of improvements appeared a tendency towards a rise during the study period, with 68.6% in 2022. The actual DALYs due to echinococcosis were lower than the estimated DALYs without interventions in Xizang, and the averted DALYs loss increased from 6 293.03 in 2017 to 11 487.84 in 2022. The average ICER for population echinococcosis screening and patient treatment was 11 460.3 yuan/year in Xizang from 2017 to 2022, with a WTP of 0.196. Conclusion Xizang has given large financial investments and achieved a satisfactory efficiency for population screening and patient treatment of echinococcosis from 2017 to 2022, with a high fund utilization efficiency. Through comprehensive screening, a large number of early-stage echinococcosis patients were identified, and surgical treatments and medication were actively arranged. However, regions with currently low screening efficiency are no longer suitable for large-scale population screening. It is recommended to adjust screening strategies and methods according to local conditions. For the treatment of echinococcosis patients, it is advised to enhance surgical training to improve surgical standards and outcomes, strengthen the standardized management of patients undergoing drug treatment, and improve medication adherence, thereby further enhancing the treatment effectiveness for echinococcosis patients.