Wegener's granulomatosis is a necrotizing vasculitis that may affect any viscera. Gastrointestinal involvement is rather uncommon. We present a case of Wegener's granulomatosis with multiple small bowel ulcers and a single ileal perforation. Histological examination of the surgically resected specimen demonstrated evidence for necrotizing vasculitis. Gross and histological features of the gastrointestinal disease in Wegener's granulomatosis are discussed.