Wegener's granulomatosis is characterized by necrotizing granulomatous vasculitis affecting upper and lower respiratory tracts and kidneys. Vascular lesions commonly involve capillaries and small vessels but, less commonly larger vessels. We report a 46-year-old male patient of Wegener's granulomatosis associated with paranasal sinusitis, pulmonary consolidations, glomerulonephritis, skin lesions with obstruction of both anterior tibial and peroneal arteries. Several necrotic lesions of the toes had progressed to gangrene and both transmetatarsal amputations were done. The patient continued to receive cyclophosphamide and prednisolone.