Malignant pleural mesothelioma (MPM) is an agressive and rare tumour, but with increasing incidence linked to previous exposure to asbestos fibers, its main etiological factor. The interest for this cancer has been stimulated by recent improvements in the diagnosis and in the treatment of mesothelioma, including new cytotoxic drugs and multimodal treatment, associating chemotherapy, radical surgery and radiotherapy in prospective, randomised and multicentric trials. The management of MPM is now better defined by the guidelines from the experts Conference of the Société de Pneumologie de Langue Française in 2005, actualised this year by the European Respiratory Society.