Mesotheliomas are neoplasms of the serosal membranes of the body cavities, arising from the pleura, peritoneum, pericardium, tunica vaginalis, testis, and ovarian epithelium. Eighty percent of mesotheliomas originate in the pleural space, and they represent the most common primary tumor of the pleural cavity. It is estimated that mesothelioma deaths in men will double over the next 20 years .Despite its relative rarity, mesothelioma remains an area of special interest in pulmonary medicine because of its increasing frequency, dismal prognosis, and attendant medico legal issues related to asbestos exposure. Mesotheliomas are classified into three general categories: diffuse malignant, localized benign, and localized malignant. Ten percent of localized mesotheliomas are malignant, but they are often low-grade and potentially resectable. Diffuse pleural mesothelioma, the focus of this review, accounts for the preponderance of primary pleural tumors.