We aimed to investigate the computed tomography (CT) findings of malignant pleural mesothelioma (MPM) caused by environmental asbestos exposure. We retrospectively reviewed CT scans of 66 patients, which were performed before any invasive procedure was done. Pleural effusion (80.3%), pleural thickening (77.2%), volume contraction (37.9%), involvement of mediastinal pleura (31.8%) and interlobar fissure (28.8%) were the most common CT findings of MPM. Although none of these findings are pathognomonic for MPM, they may provide valuable clues for the differential diagnosis, at least in patients with a history of asbestos exposure.