Australia has one of the highest rates of mesothelioma in the world and it is predicted that the incidence in asbestos related diseases will peak in the next 10 years. The Guidelines for the Diagnosis and Treatment of Malignant Pleural Mesothelioma (2013) state there is no published evidence relating to nutritional assessment and survival and/or quality of life in patients with malignant mesothelioma. Evidence-based guidelines from other cancer groups have identified that nutrition assessment and intervention is associated with better nutrition status, dietary intake, functional capacity, quality of life, and clinical outcomes. In a recent pilot study, 40% of patients with mesothelioma were malnourished using the PG-SGA. Malnutrition may occur as a result of a combination of factors including older age, symptoms associated with the disease impacting on intake, treatment side effects, development of cachexia or pre-existing problems. Dietary intake was assessed using a validated, semi quantitative diet history questionnaire. Although mean protein and energy intake were 140% and 96% of estimated requirements respectively, only 30% of participants met both protein and energy requirements. Global quality of life score measured using EORTC-QLQ-C30 was 57.9 ± 27.4, similar to the reference global QOL score for these patients (55.0±22). Comparison of symptoms with QOL reference values found our group had higher fatigue (42.1±20.1 versus 38.5±25.4), dsypneoa (50±31.4 versus 39.5±30.4), insomnia (33.3±29.2 versus 31.4±32.4), pain (41.4±28.1 versus 36.5±28.9) and constipation (28.6±36.6 versus 16.3±24.9) scores. Lower than reference scores were found with nausea and vomiting (4.8±10.2 versus 8.8±16.1) and appetite loss (16.7±25.3 versus 27.5±31). Further investigation in patients with mesothelioma is warranted to better understand the relationship between nutritional status and patient outcomes and to guide clinical practice.