A retrospective five year review of 75 patients hospitalised in Middlemore Hospital, Auckland, who underwent temporal artery biopsy shows that the procedure was performed without complications and that the result could significantly alter patient management. Patients biopsied were all 50 years or older, predominantly female (77%) and caucasian (90%). Biopsies were positive in 14 patients (18.7%). Polymyalgia was present in 64% in both biopsy positive and negative groups. Visual disturbance was more frequent in the biopsy positive group (43% versus 21%) but not statistically significant. Jaw claudication and abnormalities of the temporal artery on examination were significantly more frequent in the biopsy positive group. Final diagnoses included 16 with temporal inflammatory polyarthritis, and 4 with malignant disease. As a result of a negative biopsy corticosteroids were stopped in 13 patients, reduced in dose in 5 patients, and begun in low dose in 7 patients.