Granulomatosis with polyangiitis has many presentations and is known to cause optic neuropathies. but the mechanism of injury is usually related to mass effect from a space-occupying granuloma. In this case report. we present a patient with cranial nerve VI mononeuropathy from granulomatosis with polyangiitis secondary to inflammation alone. https://www.chiggate.com/elliot-pecan-tree-sale/