This is the presentation of a 5 month old infant male initially diagnosed with atypical Kawasaki's disease who developed disseminated coronary artery dilation and multiple aneurysms in mid-size systemic arteries. He suffered an acute bleeding event and later died. This case underscores the possibility of systemic arterial involvement in severe cases of Kawasaki's disease and raises the issue whether wider screening for extracardiac vascular abnormalities might be indicated.