In 1998, the General Directorate of Labor (DGT) and the General Directorate of Health (DGS) of their respective ministries commissioned Santé publique France to establish a national program to monitor the health effects of asbestos: the National Program for the Surveillance of Pleural Mesothelioma (PNSM), a specific marker of past asbestos exposure. To date, the PNSM has been in operation for twenty years. This report provides a key overview of trends in the epidemiological situation of pleural mesotheliomas in France between 1998 and 2017, in terms of incidence, survival, exposure among affected patients, and their medical and social recognition.Despite the ban on asbestos use in 1997 and due to the 30- to 40-year latency period between initial exposure and the onset of mesothelioma, the incidence of pleural mesothelioma continues to rise in France, and this increase is even more pronounced among women, with the number of new cases per year having doubled since 1998.Over the 2015–2016 period, an estimated 1,100 new cases of pleural mesothelioma occurred annually in France, 27% of which were in women.Furthermore, there is significant geographic variation in incidence. More than 90% of men were occupationally exposed to asbestos during their careers. This proportion has remained stable since 1998, although the focus has shifted from occupations involving the use and processing of asbestos to those involving work on asbestos-containing materials (construction sector, asbestos removal, etc.).Among women, the proportion of occupational asbestos exposure remains low (approximately 40%), and 35% of women were exposed outside of work. This exposure most often results from living with spouses or relatives who are occupationally exposed, domestic exposure (asbestos-containing objects or building materials in the home), or DIY projects. For 25% of women, none of these exposure sources are identified. The use of compensation mechanisms (recognition as an occupational disease and the Asbestos Victims Compensation Fund —FIVA) by people with pleural mesothelioma remains insufficient, with 27% of cases under the General Social Security System (RGSS) taking no action and 53% of cases outside the RGSS not seeking compensation through FIVA. The information provided by PNSM investigators regarding compensation programs has had a positive effect, resulting in a higher rate of claims than in areas outside the PNSM.It is essential to strengthen prevention efforts targeting current asbestos exposure, among workers and young people in training, as well as the general public and healthcare professionals.It is essential to increase awareness-raising efforts regarding the options for utilizing existing medical-social recognition systems, both among healthcare professionals and among patients.The implementation of the National Mesothelioma Surveillance System (DNSM), which integrates the PNSM and mandatory reporting (DO), will soon take effect. This will make it possible to modernize and optimize the surveillance of all types of mesothelioma (pleural, peritoneal, etc.) nationwide, adapt it to new challenges, refine the investigation system, and strengthen its integration with research efforts.