Although Henoch-Schönlein Purpura (HSP) is widely believed to be a benign, self-limited form of vasculitis, this generalization, when applied to adults, may not be valid.We describe five patients with prolonged severe vasculitis, all of whom met American College of Rheumatology criteria and carried a clinical arid tissue diagnosis of HSP. In each case, the vasculitic manifestations necessitated treatment with steroids and/or immunosuppressant therapy. This experience suggests that the benign histopathology of HSP in adults does not guarantee a benign clinical course.