Background: Temporal arteritis is a systemic granulomatous vasculitis affecting large and medium sized arteries. Scalp necrosis is a rare complication that can appear before, during and after treatment.

Methods: A patient with temporal arteritis and scalp necrosis is presented and relevant literature reviewed.

Results: Scalp necrosis is seen in a few patients with temporal arteritis. The skin manifestations are most often bilaterally distributed and localised to the frontal, parietal and temporal parts of the scalp. Scalp necrosis often signifies a severe and extensive vasculitis, and is therefore associated with a high incidence of other disease-related complications, among them visual disturbances and blindness.

Conclusions: Awareness of scalp necrosis as a complication of temporal arteritis could reduce unnecessary time-consuming assessments and lead to a more rapid diagnosis and start of treatment.