Malignant pleural mesothelioma (MPM) is a fatal tumor, which spreads aggressively and highly resists conventional chemotherapeutic agents. It continues to be a difficult clinical problem, and efficient treatment is still an enormous challenge. Alimta is used currently as an anti-MPM medicine, obtained mainly through chemical syntheses. Meanwhile, phenanthroindolizidine alkaloids such as tylophorine and cuevaene A, diterpenes such as cafestol and kahweol, naphthoquinones such as JBIR-76 and JBIR-77, anagucycline C-glycosides, and dodecahydrodibenzo [b,d]furan skeletons such as JBIR-23 and JBIR-24 have been isolated and found with different cytotoxic effects against several MPM cell lines. The present short review summarizes the synthetic strategies of these anti-MPM molecules.