Malignant pleural mesohelioma is a rare type of highly invasive cancer that is mainly related to asbestos exposure. Despite application of different modalities such as chemotherapy, radiotherapy and surgery, the therapies remain ineffective.and the prognoses remain very poor. Immunotherapy has gradually become a hot spot in cancer treatment in recent years. The breakthrough finding is that blocking T cell immunologic checkpoint molecules can reactivate the killing effect of T cells on tumor cells. Immunological checkpoint inhibitors have changed the clinical practice of cancer therapy. In 2011, the CTLA-4 inhibitor ipilimumab was approved by the US FDA and became the first immune checkpoint inhibitor in market. In 2014, nivolumab was approved to become the world's first PD-1 inhibitor to open to market. Several years later, multiple immune checkpoint inhibitors, including PD-1/PD-L1 antibodies, were approved to be adaptable to multiple cancers, including non-small cell lung cancer, gastric cancer, and liver cancer. From the study of DETERMINE, KEYNOTE-028 to the PROMISE-Meso study, immune checkpoint blockades monotherapy has been proved to be effective and relatively safe for the treatment of MPM. A comparative study of immunological checkpoint inhibitors as first-line treatment and chemotherapy is also under way, combined treatment (including the combination of immunological checkpoint inhibitors treatment and chemotherapy) research is also ongoing. The study of biomarkers of immune checkpoint inhibitors has promoted the precise immunotherapy of MPM.