Non-healing granulomata of the upper or lower respiratory tract often cause diagnostic and therapeutic problems. A case of Wegener’s granulomatosis is reported, which during the first year of illness presented only with signs of a laryngeal granuloma. When severe renal disease developed and cytostatic therapy was prompted, the laryngeal lesion showed an excellent response to the treatment. The case illustrates the diffculties encountered in the management of patients with Wegener’s granulomatosis.