In the period 1988-1999, the Tuscan Mesothelioma Registry (ARTMM) recorded 436 cases of pleural malignant mesothelioma (MMP); 81% were males. The Tuscan MMP incidence rate (age standardized on European population; per 100,000 per year), was 0.97 in 1988-1993, 1.64 in 1994-1999 for males; 0.22 and 0.23 for females, respectively. In the period 1988-1999 the Tuscan Mortality Registry (RMR) recorded 676 pleural cancer (TMP) deaths (ICD IX 163; 464 in males). In the periods 1988-1993 and 1994-1999 Tuscan TMP mortality rate (per 100,000 per year) was 1.54; 1.70 for men; 0.46 and 0.53 for women, respectively. The highest incidence and mortality rates for males were recorded in Massa Carrara (MMP incidence in the period 1994-1999: 5.20) e Livorno (MMP incidence in the period 1994-1999: 4.64) provinces. In order to study differences between incidence and mortality for males, an analysis of distribution of incident MMP cases and TMP deaths by municipality in Tuscany was carried out. It is usually assumed for projections of MMP mortality that the ratio of MMP mortality to TMP mortality is 1:1. However, in order to evaluate more precisely projections of MMP mortality, the exact ratio was calculated for men. In the period 1994-1999, 82% (154/188) of the male MMP deaths were correctly coded as TMP deaths in the RMR; 60% (154/256) of male TMP deaths were definite MMP cases, as they were recorded in ARTMM. The ratio of MMP mortality to TMP mortality is, therefore, 0.73:1 (0.60/0.82) for males in Tuscany.