Editor,—Giant cell arteritis (GCA) presents either as localised or systemic vasculitis and is found typically in individuals older than 50 years and is often associated with polymyalgia. GCA involves most frequently the temporal artery and may be bilateral. Other affected vessels include aorta, carotid, vertebral, ophthalmic and, rarely, coronary arteries. Headache, jaw claudication, and scalp tenderness are frequent complaints. Anterior arteritic ischaemic optic neuropathy is the best known, most common, and severe neuro-ophthalmic manifestation. We describe the case of a patient with third and sixth cranial nerve palsy, as well as suspected liver involvement as presenting signs in GCA.