Malignant pleural mesothelioma (MPM) is a relatively rare tumour, mainly associated with occupational exposure to asbestos. We retrospectively analysed the records of MPM patients treated at the Pulmonology Department of the Clinic for Internal Diseases, Clinical Hospital Centre Rijeka between 1989 and 2008. to establish the incidence of MPM in that period. Between 1989 and 2008 the hospital received 121 MPM patients, 117 of whom were men and four women. We observed a continued increase in newly diagnosed MPM patients from year to year. Occupational exposure to asbestos was established in 72 patients who worked in shipbuilding. In our region the incidence of MPM has been rising significantly. We believe that this is not related to improved diagnostics, but to the long latency of the disease. This is why we expect this trend to continue for a while. In the U.S.A. and Europe, MPM incidence is expected to peak by 2020, while in countries with poor control over asbestos use this may take longer.