Abstract: Objective: To summarize the experience of diagnosis and management of malignant peritoneal mesothelioma. Methods: We reviewed the clinical data from 22 patients with malignant peritoneal mesothelioma who were admitted in our hospital in the past 40 years. Results: All of the diagnosis were proved pathologically, 9 males and 13 females, with a median age of 49,(range 18~72 years). Thirteen cases underwent cytoreductive surgery and intraperitoneal and/or systematic chemotherapy, 1 case received cytoreductive surgery and abdominal regional radiotherapy, 4 cases had laparotomy exploration and intraperitoneal and/or systematic chemotherapy, 1 case received intraperitoneal and systematic chemotherapy without surgery, and 3 cases only received systematic chemotherapy. The median survival time was 18.5 months, and there were 3 patients who survived over 5 years. Conclusion:The diagnosis of malignant peritoneal mesothelioma is difficult, and its prognosis is poor. Diagnostic methods include laparotomy exploration, ascites cytological examination, fine needle biopsy guided by B- US, and biopsy by laparoscope. Surgical cytoreduction combined with chemotherapy is the main management.