Here, we report an extremely rare case of Malignant Peritoneal Mesothelioma (MPM) with chronic hepatitis B cirrhosis. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in a Middle-aged 58-year-old man showed peritoneal effusion, a smaller size liver, the abdominal cavity with obviously abnormal signal and unclear border around two huge mixed density shadows. Color Doppler ultrasound examination showed a hypoechoic mass located below the left kidney and right left kidney, respectively. Histopathological examination showed that the tumor was composed of spindle cells with large quantities collagen fibers. Whereas, Epithelial Membrane Antigen (EMA), Calretinim, AE1/AE33 showed negative results by immunohistochemical examination. A fibrous mesothelioma was strongly suspected. The patient refused surgery and did not receive chemotherapy. Currently, the patient has been taking Gleevec and has a relatively stable condition.