Malignant pleural mesothelioma is a rare malignancy of the pleura, involving a large extent of the pleural cavity. It is associated with a poor prognosis; with an average survival of less than 2 years from diagnosis. There is a strong etiologic correlation between asbestos exposure and pleural mesothelioma, however unusual presentations are reported, though rarely. The diagnosis is suspected with a chest skiagram and CT Scan and confirmed by a pleural biopsy. Here we are reporting a case of hemorrhagic pleural effusion in a 48 year old male with no history of asbestos exposure. The rarity and implications of this unusual presentation are also discussed.