Microscopic polyangiitis nodosa (MPA) is a necrotizing vasculitis that affects small vessels, typically associated with myeloperoxidase anti-neutrophil cytoplasmic antibody. Cerebrovascular diseases are rarely reported to be associated withMPA. A 41-year-old male patient presented to the emergency room with complaints of speech difficulty and loss of strengthon the left upper extremity, and MPA was detected with cerebral hemorrhage and renal failure. The case report, just as wefirst defined with this case in the national literature, was presented to emphasize that MPA may be rarely demonstratedwith symptoms of cerebrovascular involvement except for commonly seen organ involvement.