Between 1985 and 1987 a total of 521 people underwent temporal artery biopsy with no histological evidence of arteritis in Göteborg, Sweden. Two-hundred-and-twenty people were diagnosed as having polymyalgia rheumatica (PMR). Among the patients without PMR 30% had rheumatic, 17% malignant and 14% infectious disorders. The annual incidence of PMR with negative biopsy was 17/100,000 and for the population over 50 yr it was 50/100,000. We found an increased mortality in vascular diseases among men with PMR in the first 2 yr after diagnosis with 13 observed deaths compared to the expected six (P < 0.01). There was also a tendency toward an increased mortality among the women with 16 observed deaths compared to the expected 11 (not statistically significant). The mortality in malignant diseases was not increased.