Two cases of rare malignant mesothelioma of tunica vaginalis testis are presented. Both cases were advanced on clinical and radiological studies. One patient was treated with surgical excision followed by chemotherapy and radiotherapy and the other patient was treated with surgery and chemotherapy. Despite aggressive therapy both the patients died within 18 months of treatment. Review of the literature with suggested treatment protocol is presented. The response of malignant mesothelioma to chemotherapy and radiotherapy is poor as indicated by both of our cases. Initial aggressive surgery and adjuvant procedures are necessary soon after diagnosis to achieve long-term survival.