In 1998, the General Directorate of Labor (DGT) and the General Directorate of Health (DGS) 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). This report provides an overview of trends in the epidemiological situation of pleural mesotheliomas in France between January 1, 1998, and December 31, 2023, in terms of incidence, exposure conditions, and the medical and social recognition of patients. Despite the ban on asbestos use in 1997—but due to the latency period of at least 30 years between initial exposure and the onset of mesothelioma, as well as ongoing occupational and environmental exposure— the incidence of pleural mesothelioma continues to rise in France, and this increase is even more pronounced among women. During the period 1998–2023, 7,277 cases of mesothelioma were included in the PNSM. Over this period, analyses show a decrease in the sex ratio (from 4.1 male cases per 1 female case at the beginning of the period to 3.4 at the end) and an increase in age at diagnosis, accompanied by a decrease in the proportion of “young” patients under 60 years of age (from 16% to 4%). A significant geographic disparity was observed throughout the 1998–2023 period. On average, the number of new patients is around 1,100 per year. Between the 1998–2001 and 2018–2021 periods, the number of patients increased sharply among both men and women. However, when accounting for the demographic effect of population aging, the incidence continues to rise, though more slowly among men (+2% over the same period) than among women (+16%). There has been an improvement in the rate of confirmed diagnoses (92% in 2018–2023 compared to 74% in 1998–2002). Over the 2018–2023 period, among men, exposure to asbestos was overwhelmingly linked to occupational history (more than 90% of cases in the most recent years). A longer latency period for mesothelioma has been observed (exceeding 50 years for new cases in the most recent inclusion period). The occupations associated with exposure remain largely the same, with certain professions slightly more common, such as skilled metalworkers and locksmiths, as well as those in the general masonry sector. Among women, occupational exposure to asbestos was found in only one out of three cases, with non-occupational exposure representing the majority of cases. However, the overall results for women remain difficult to analyze due to their small sample size in the PNSM. Regarding claims for compensation, over the 2005–2023 period, more than half of the patients included in the PNSM filed a claim with the Asbestos Victims Compensation Fund (FIVA). Among those enrolled in the general Social Security system, 56% filed a report of occupational disease (DMP), while one-quarter took no action. There is significant geographic variation in the number of claims. Younger patients (under 65 years of age), who live with a partner and have been occupationally exposed to asbestos, are more likely to file a DMP and seek compensation from the FIVA. In conclusion, asbestos remains a public health issue. It is essential to strengthen prevention efforts targeting asbestos exposure among workers—who constitute the most exposed population—by raising awareness, particularly among young people in training. Exposure among the general population varies and requires further investigation. Santé publique France is implementing a new mesothelioma surveillance system covering the entire French territory and is refocusing its efforts on monitoring incidence and exposure conditions in order to continue providing information useful for prevention.