This paper reviews the radiological features of 20 patients with Wegener's granulomatosis and seven cases of lethal midline granulomas. It compares the findings of plain sinus radiographs and tomography. There are no specific radiological features of either Wegener's granulomatosis or lethal midline granuloma. Plain sinus radiographs underestimate the extent of bony changes and the differences between Wegener's and lethal midline granulomas are one of degree. Computerised tomography will show the extent of the disease. The role of nuclear magnetic resonance is also discussed. Nuclear magnetic resonance does not show bone destruction but the T2 weighted response of the tissues helps to differentiate the condition from neoplasia. The literature is reviewed and compared with the study.