Malignant mesothelioma is an uncommon tumour with an inevitably poor outcome. Statistics from the US National Cancer Institute reveal a steady rise in its incidence over the past 25 years. It typically arises from the pleura, but can also originate in the peritoneum, pericardium, genital tracts and tunica vaginalis. Previously considered a local disease with low incidence of metastasis, there is increasing evidence suggesting otherwise. Reported cases of cerebral metastasis are rare and the vast majority are postmortem findings. This report documents a patient with symptomatic cerebral metastasis from malignant mesothelioma, who underwent craniotomy and excision of two cerebral lesions. It is one of a handful of case reports in the literature in which histological confirmation has been obtained ante-mortem and where surgical treatment of the intracranial mesothelioma was undertaken.