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This article studies the rough approximation of a vague concept based on multiple granularity over two universes. With the description of the background of risk decision making problems in reality, we first present the optimistic multigranulation rough vague set, pessimistic multigranulation rough vague set and variable precision multigranulation rough vague set on the multigranulation approximation space over two universes. Then, under the multigranulation fuzzy approximate space over two universes, we establish the corresponding three types of multigranulation vague rough set over two universes. Subsequently, the interesting properties and results as well as the relationship between the multigranulation rough vague set models and multigranulation vague rough set model over two universes are investigated in detail. The results show that multigranulation vague rough set models are extensions of the existing generalized rough set models under the framework of two universes. At the same time, we construct a new approach to group decision making under uncertainty by using the theory of multigranulation vague rough set over two universes. The basic principal and the detailed steps of the decision making model given in this paper are presented in detail. Meanwhile, an example of handling a medical diagnosis group decision making problem illustrates this approach. The main contribution of this paper is twofold. One is to provide the theoretical model of multigranulation vague rough set over two universes. Another is to try making a new way to handle group decision making problems under uncertainty based on multigranulation vague rough set theory and methodologies over two universes. [ABSTRACT FROM AUTHOR]