Introduction: Intracranial hydatid cysts are rare supra-tentorial lesions in the neurosurgical population of India. Methodology: In this report, we presented a case of a 18 year old male patient with midline shift, posted for excision of hydatid cyst in brain. The use of dexmeditomidine alongwith sevoflurane for anesthetic induction helped in achieving optimal intra-operative brain relaxation and a good surgical outcome for this patient. Results: Neuroanesthetic monitoring for this patient encompassed the state entropy monitoring, cerebral blood flow velocity monitoring, non-invasive intra-cranial pressure monitoring and analgesia monitoring in conjunction to the standard ASA monitoring. Conclusion: The authors advocate similar management for achieving optimal standard of care while operating giant cystic lesions in supra-tentorial compartment.