Although it can remain stable for prolonged periods, malignant mesothelioma (MM) is an aggressive tumor usually associated with asbestos exposure. Herein we present a case of pleural MM characterized by recurrent exudative pleurisy. A 33-year-old male admitted to our department for four times due to recurrent right pleural effusion within 21 months. His pleurisies were subsided with or without any therapy. At his last admittance a diagnosis of malignant mesothelioma was obtained by open pleura biopsy. After six cycles of chemotherapy, he is still free of any symptoms and no recurrent pleurisy was detected. This is a rare case of malignant mesothelioma showing recurrent pleurisy episodes, and spontaneous regressions without any apparent radiological findings. Pleurisies with effusions may be due to anti-tumor immune response or a predisposing factor for the development of malignant mesothelioma. [Turk J Cancer 2006;36(3):142-145].