Typical radiological findings in patients with diffuse malignant pleural mesothelioma are nodular opacities of the pleura including the fissures, pleural effusion, shrinking of the ipsilateral hemithorax, and mediastinal shift. The radiological differentiation between pleural mesothelioma and benign pleural tumors is possible; however, a secondary metastatic pleural involvement imitates pleural mesothelioma. Magnetic resonance imaging is superior to computed tomography in the preoperative assessment of tumor extension, because it demonstrates exactly the tumor extension in the coronal or sagittal plane. The noninvasive ultrasound examination is helpful in the evaluation of the diaphragmatic pleura and the costodiaphragmatic spaces.