Scalp and tongue necrosis are rare ischemic manifestations of giant cell arteritis (GCA). Early recognition of these conditions is crucial to preventing permanent visual loss (PVL). We present two cases of scalp and tongue necrosis, respectively, where a delay in diagnosis resulted in irreversible vision loss and severe complications. These cases highlight the importance of educating non-rheumatologists about these manifestations to ensure prompt steroid treatment, which can prevent vision loss and reduce morbidity in GCA patients.