We studied chemokine receptor expression in malignant mesothelioma (MM), reactive mesothelium (RM), and leukocytes in effusions. The expression of leukocyte markers (CD3, CD4, CD8, CD14, CD16, and CD19) and chemokine receptors (CXCR1, CXCR4, CCR2, CCR5, and CCR7) was studied in 11 MM and 16 RM specimens using flow cytometry. RM specimens showed higher lymphocyte counts (mean rank, 17.6 vs 8.8; P = .004), whereas monocyte numbers were higher in MM (mean rank, 19.5 vs 10.2; P = .002). CXCR1 (P =.006) and CXCR4 (P = .036) expression was higher in MM monocytes. Chemokine receptors were infrequently expressed in MM (0-2/11 effusions per receptor), whereas RM specimens were uniformly negative. Chemokine receptors are widely expressed on leukocytes in MM and RM effusions but are infrequently found on cells of mesothelial origin. This finding suggests a major role for an autocrine chemokine pathway in leukocytes but not in MM cells. The increased monocyte infiltration and their higher chemokine receptor expression in MM effusions may have a tumor-promoting rather than tumor-inhibiting effect.