A 36-year-old man with acute onset of Wegener granulomatosis was treated with antilymphoblast globulin, azathioprine, and prednisone. Both pulmonary and renal failure had been present and both considerably improved with immunosuppressive therapy. However, renal failure persisted and renal allotransplantation was carried out more than one year ago. The patient is now well, with normal renal and pulmonary function. To our knowledge, this appears to be the first case of fulminant pulmonary and renal Wegener granulomatosis successfully treated with immunosuppressive drugs and renal transplantation.