Malignant pleural mesothelioma (MPM) is a rare tumor that originates in the lung pleura; it commonly results from previous asbestos exposure that occurred between 20 and 50 years prior to disease onset, and its incidence is increasing worldwide. Symptoms commonly related to MPM include chest pain. The causes of the pain are multifactorial: it may be due to tumor infiltration of the ribs of the nerve roots, intercostal nerves, chest wall, or, in some cases, from tumor invasion of the neurovascular bundle. Treatment of chest pain makes use of medical therapy, surgical and radiotherapy approaches.