An 80-year-old male patient with histologically confirmed temporal arteritis presented with two very rare complications: ocular hypotony and bilateral scalp necrosis. The intraocular pressure gradually normalized on high-dose cortisone therapy. Scalp necrosis was surgically removed and covered with a split-skin graft with good incorporation of the transplant. Scalp necrosis as well as ocular hypotony are serious complications of temporal arteritis, indicating a poor prognosis. To date three similar cases have been reported in the literature.