Introduction: Goodpasture's disease with central nervous system involvement is extremely rare.
Case report: We report a 62-year-old woman with Goodpasture's disease (GD) associated with the presence of perinuclear anti-neutrophil cytoplasmic antibodies, complicated by spinal subarachnoid hematomas and cerebral infarctions. In spite of aggressive treatment, the patient died.
Conclusion: GD and anti-neutrophil cytoplasmic antibodies vasculitis should be suspected in patients presented with renal insufficiency with spinal and/or brain involvement.