A detailed review of the literature was done to define the epidemiology, pathology, clinical features and treatment of pleural mesothelioma. It appears that pleural mesothelioma accounts for approximately 400 deaths each year in the USA. Asbestos was definitely implicated in the etiology of this disease. The common clinical features include chest pain, pleural effusion and radiologic findings of irregular pleural thickening or pleural densities. Therapeutic modalities used in the past included surgery, radiation therapy, and, more recently, chemotherapy. A combined modality approach to treatment appears more promising.