The referral for treatment of a patient with nasal and pulmonary lesions typical of Wegener's granulomatosis occasioned investigation of the role of adrenal corticosteroids in its treatment. Reports of eight cases including sufficient detail to be helpful were found. Of these, remissions of 3 to 26 months coincided with treatment in four. Therefore, a determined trial of continuous treatment with relatively large daily doses of steroids was begun. On two occasions, cessation of therapy and reduction of dosage allowed definite clinical relapses eventuating in the patient's death 8 months after onset. Numerous complications of therapy occurred but were controlled. Autopsy findings confirmed the clinical diagnosis. It is felt that this experience should favor rather than discourage further prolonged trials of large doses of adrenal steroids in similar patients with Wegener's granulomatosis.