In this study, we evaluated the efficiency and the toxicity of three dimensional conformal hemithoracic radiotherapy (3DCHRT) after extra pleural pneumonectomy (EPP). The median age of 14 patients were 51 years (range, 33-61 years). Most commonly seen histopathology was epitheliod type (79%). According to American Joint Commission on Cancer (AJCC) 2002 staging system 9 cases (64%) were stage III. A total median dose of 50.4 Gy was applied to hemithoracic cavity. Eleven patients received adjuvant chemotherapy. 3DCHRT was generally well tolerated. The acute toxicities of 3DCHRT were grade I-II. After a median of 16 months follow-up, intrathoracic control was 100%. Six patients (43%) developed abdominal relapse and one (7%) developed distant metastasis. Nine cases were dead with two of them being without the evidence of disease. Excellent local control with 3DCHRT after EPP seems to change the relapse patterns of MPM. More effective systemic treatment is needed to prevent the recurrences outside thorax.