For the first time in his Royals career, 31-year-old Meche did not receive the opening day nod for Kansas City in . Instead he was slated as the number-two starter behind reigning AL Cy Young Award winner Zack Greinke. Hampered by injuries again, Meche spent considerable time on the DL in 2010 and was 0–4 with a 6.66 ERA after making his final career start on May 25. After five rehab appearances with the Northwest Arkansas Naturals and Omaha Royals, Meche returned to the Royals as a reliever that September. He made eleven appearances, giving up three earned runs in thirteen innings.