Malignant pleural mesothelioma is the most common primary neoplasm of the pleura. Imaging evaluation is essential in diagnosis, staging, and assessment of treatment response in malignant pleural mesothelioma. Computed tomography is the most commonly used modality for tumor staging. Assessment of tumor extension and lymph node involvement is essential in imaging evaluation as locally advanced tumors are amenable to resection. Knowledge of the full imaging spectrum of this rare disease, differential diagnosis, staging classification, and the current guidelines for diagnostic evaluation and follow-up are essential in accurate interpretation to optimize patient management.