Wegener’s granulomatosis is an idiopathic necrotizing granulatous vasculitis that can hold small and medium arteries, upper respiratory tract, lung and kidney involvement. It’s an ANCA associated vasculitis. c-ANCA positivity is considered very sensitive. In our case, a 40-year-old female patient was admitted to our hospital with complaints of nasal bleeding and crusting. The patient was operated due to idiopathic nasal septal perforation, was seen saddle nose deformity and 3x4 cm in size perforation in anterior septum and 1x2 cm in size perforation in posterior septum. Nasal biopsies of the patient with C-ANCA positivity were taken and the result of pathology came in harmony with Wegener’s granulomatosis. The patient was directed to the related clinic for the treatment of Wegener’s granulomatosis. Wegener Granulomatosis, which enters the diagnosis of idiopathic nasal septal perforation, is a disease that should be kept in mind.