Malignant pleural mesothelioma (MPM) is an uncommon but aggressive tumor of the pleura with a poor prognosis. MPM in most patients is detected initially on chest radiographs. The vast majority of patients have pleural effusion and nodular thickness of the pleura. Here, we reported the case of a patient with pleural tumor that was found incidentally on computed tomography. Early-stage MPM was confirmed after video-assisted thoracic surgery. The patient was given adjuvant chemotherapy and experienced no recurrence or metastasis during a 2-year follow-up.