While remission is achieved in the majority of Wegener's granulomatosis (WG)-patients with cyclophosphamide, maintenance of remission remains a challenge due to the high rate of relapses. The purpose of this study was to evaluate the safety and efficacy of the combination of methotrexate (MTX) plus leflunomide (LEF) for the treatment of minor relapsing WG not warranting cyclophosphamide.