The purpose of this study was to identify factors affecting long-term outcomes after complete resection of solitary fibrous tumors of the pleura (SFTP).This was a single-center retrospective study using data from patients operated on from January 1980 to December 2010.Of the 157 patients (72 men, 85 women; median age, 58 years [13–87 years]), 60 (38%) had symptoms. All patients had complete en bloc resection with wedge lung excision (n = 122), lobectomy (n = 15), bilobectomy (n = 3), segmentectomy (n = 1), pneumonectomy (n = 4), chest wall resection (n = 8), diaphragm resection (n = 3), or multilevel hemivertebrectomy (n = 1). The tumors were pedunculated (n = 89) or sessile (n = 68). Definitive histologic examination showed benign tumors (bSFTP) in 90 patients (57%) and malignant tumors (mSFTP) in 67 (43%) patients. Compared with the bSFTP group, the mSFTP group had significantly larger tumors (13.4 cm vs 6.4 cm; p < 0.0001) and a nonsignificantly higher proportion of symptomatic patients (58% vs 23%). Overall operative mortality and morbidity rates were 0.6% and 5.7%, respectively, with no significant difference between patients with mSFTP and those with bSFTP. The 5-year survival rate was better in patients with bSFTP than in patients with mSFTP (96% vs 68%; p = 0.0003). Tumor recurrence was more common in patients with mSFTP than in those with bSFTP (16% vs 2%; p < 0.0001) and was associated with decreased survival (p = 0.02). Sessile tumors (p = 0.05), CD34-negative tumors (p = 0.005), and extensive surgical procedures (p = 0.04) were significant risk factors for tumor recurrence.Complete en bloc resection of SFTP provides good long-term survival. Tumor recurrence is the main risk factor for death and may occur in mSFTP despite en bloc resection and requires multimodal treatment and close follow-up.