Malignant pleural mesothelioma is a rare aggressive disease with a poor prognosis and usually modest responses to chemotherapy. Complete responses (CRs) to chemotherapy are rare. Evaluation is usually based on radiology, and CR is therefore clinical CR (cCR) and whether this indicates absence of viable tumor cells is unknown. We have observed two cases of CR which at subsequent surgery were histologically verified, thus being pathologic CRs (pCRs). pCR after chemotherapy is thus possible but rare, and we here present the cases from our institution together with a review on the literature available on the subject.