Vasculitides are a diverse group of systemic diseases characterised by inflammation of blood vessels of all sizes, leading to a wide range of clinical manifestations. Misdiagnosis and delayed recognition are common pitfalls due to overlapping symptoms with infections, malignancies and other autoimmune disorders. A high index of suspicion is essential, particularly in patients presenting with systemic symptoms, multisystem involvement or hallmark features such as palpable purpura, mononeuritis multiplex or unexplained renal abnormalities. Over-reliance on autoantibody testing, such as anti-neutrophil cytoplasmic antibodies, can lead to diagnostic errors, emphasizing the need for integration of clinical, serologic, imaging and biopsy findings. In large-vessel vasculitis, early use of temporal artery biopsy or imaging techniques like positron-emission computed tomography is crucial to prevent complications such as vision loss. Managing corticosteroid therapy remains a challenge, requiring careful tapering, use of steroid-sparing agents and vigilant monitoring for relapse. Recognising and addressing organ-specific involvement through multidisciplinary care are critical to preventing irreversible damage and optimising outcomes. Early recognition and a comprehensive diagnostic approach are key to successful management.