Secondary stabbing headache has been infrequently reported as a m anifestation of giant cell arteritis, intracranial aneurysm, cerebral atherosclerosis, or m eningioma. W egener's granulomatosis is a multi-system autoimmune disorder characterized by necrotizing granulomatous vasculitis predominantly in respiratory tract and kidney. H eadache is a very rare presenting symptom in these patients because m ost neurological symptoms are caused by involvem ent of peripheral nervous system. W e report a 61-year-old m an w ith stabbing headache as a presenting m anifestation of W egener's granulomatosis. Korean Journal of Headache 7(1):53-56, 2006