Objective To understand the current prevalence and epidemiological characteristics of echinococcosis in Ningxia, so as to provide the references for its better prevention and control. Methods One village was chosen from each of eight endemic countries including Helan, Pingluo, Tongxin, Xiji, Yanchi, Yuanzhou, Zhongning and Haiyuan in Ningxia as monitoring site and all villagers with age over 3 years old from these eight monitoring sites were examined for hydatid cysts by abdominal ultrasound imaging. The dog fecal samples were collected from each site for detecting Echinococcus antigens by ELISA. The sheep’s visceral organs were collected for examining the hydatid cysts by necropsy. Results Among the 16 058 villagers receiving B ultrasound examination, 53 were detected to have hydatid cysts (0.33%). Most of the hydatid cysts were identified in livers (94.3%, 50/53). Among the eight monitoring sites, the villagers in Zhongning had the highest detection rate of hydatid cysts(1.40%, 28/2 002), there was no cyst detected in Pingluo and Yanchi, with statistical difference in the distribution of hydatidosis in different countries (P < 0.05). Females had the higher detection rate of hydatid cysts (0.34%, 29/8 434) than male villagers(0.31%, 24/7 624) (P < 0.05). The old villagers with age ≥ 60 years had the highest detection rate (0.81%, 29/3 574) compared to other age groups with statistical difference (P < 0.05). The Echinococcus coproantigen was detected in 12 dog fecal samples from total 1 134 collected dog feces with Echinococcus infection rate of 1.06%. Out of 6 226 sheep visceral organs examined, the hydatid cysts were identified in 87 organs with Echinococcus infection rates of 1.40% in sheep. There was significant difference in the detection of dog Echinococcus coproantigen and the sheep Echinococcus infection rate among the different monitoring sites(P < 0.05). Conclusion The prevalence rate of Echinococcus infection in human, dogs and livestock still remains high in some endemic areas in Ningxia and the further efforts and measures are needed for preventing and controlling of echinococcosis in Ningxia.