Abstract The prognostic role of mitotic and apoptotic indices in 60 patients with malignant mesothelioma was examined on hematoxylin-eosin-stained sections. The findings were compared with apoptotic indices determined by in situ end labeling (ISEL) in 35 of the cases. There was a significant survival advantage associated with lower mitotic counts and a lower apoptotic index defined by ISEL ( P < .05). There was no association between the apoptotic index derived from the hematoxylin-eosinstained sections and prognosis (P = .90). However, there was a positive association between the apoptotic counts calculated from hematoxylin-eosin- and ISEL-stained sections ( P < .01). The mitotic count and ISEL apoptotic index are potentially useful markers of prognosis in malignant mesothelioma.