The findings of this retrospective dual-center cohort study of diffuse malignant peritoneal mesothelioma (DMPM) patients suggest that pembrolizumab had clinical activity regardless of PD-L1 status or histology, though patients with nonepithelioid histology may have benefited more. The partial response rate of 21.0% and median OS of 20.9 months in this cohort with 75.0% epithelioid histology call for additional research to identify those most likely to respond to immunotherapy.