Two patients with clinical features consistent with giant cell arteritis were found to have systemic cholesterol microembolization syndromes. Diagnostic confirmation was established by a muscle biopsy in one patient and by a kidney biopsy in the other. Systemic cholesterol embolization can masquerade as a variety of disorders, including vasculitis, and should be considered in a patient with suspected giant cell arteritis who has a negative temporal artery biopsy.