Giant cell arteritis is a rare disease that can lead to blindness in people older than 50 years. Early recognition and timely treatment can prevent irreversible damage. Early recognition can be challenging due to the variable presentation of giant cell arteritis. Patients suspected of having giant cell arteritis should be referred within 24 hours to a hospital that ideally has a fast-track clinic, including vascular imaging. Here we present two patients with giant cell arteritis that reflect a number of dilemmas regarding early recognition and treatment, the fast-track clinic and the early start of prednisolone-sparing drugs in giant cell arteritis.