Objectives. The main objectives of the National Mesothelioma Surveillance Program (PNSM) are to estimate trends in the incidence of mesothelioma and the proportion attributable to asbestos exposure, to evaluate the management of pleural mesothelioma as an occupational disease, and to contribute to research. Methods. In 22 departments, a standardized procedure for the registration and pathological and clinical confirmation of primary pleural tumors is implemented. Data on lifetime exposure to asbestos and other factors studied (ionizing radiation, FCR, etc.) are collected; a case-control study was also conducted. An analysis of the reporting and recognition procedures for mesotheliomas registered as occupational diseases allows for an assessment of the proportion of reported and compensated cases. Results. For the period 1998–2003, the estimated annual number of new cases ranges from 646 to 800. The sectors of activity and occupations with the highest risk of mesothelioma have been identified. The proportion attributable to occupational exposure to asbestos among men was estimated at 83.2%. Over the 2002–2004 period, 67% of patients filed a claim for recognition as an occupational disease, and 92% of them received compensation. Conclusions. The PNSM provides important information for understanding mesothelioma and allows for the monitoring of trends in many aspects of this disease at the national level. (R.A.)