We evaluated angiograms of 26 patients with polyarteritis nodosa (PAN) as well as the associated clinical and laboratory features. All patients had visceral angiograms and either biopsy or angiographic proof of PAN. Severe disease was defined as central nervous system PAN, renal failure requiring dialysis, gangrene of fingers or toes, cardiomyopathy, bowel infarction, hepatic failure, or hepatic infarction. The presence of aneurysms was associated with severe hypertension, hepatitis B surface antigenemia and clinically severe disease. Angiography may therefore identify a subset of patients with more severe involvement and may be of value in management decisions.