From 1982 through 1987, 107 patients underwent temporal artery biopsy at the Lahey Clinic. In 29 patients, biopsy revealed temporal arteritis (TA). These patients had appreciably more jaw claudication, anemia, anorexia and a higher erythrocyte sedimentation rate (ESR) than patients whose temporal artery biopsy revealed negative findings. Certain clinical criteria and symptom clusters, which include jaw claudication, are highly specific for positive results on temporal artery biopsy. Length of arterial segment examined and previous corticosteroid therapy did not influence the results of temporal artery biopsy. TA should be confirmed histologically whenever possible. When results of biopsy are negative, patients fulfilling clinical criteria or having symptom clusters specific for TA should receive steroid treatment.