Purpose: Temporal arteritis may cause severe visual loss. The literature suggests that this visual loss is permanent. Our aim was to determine the natural history of vision over time in such patients. Methods: Fifteen patients with biopsy proven temporal arteritis from 1990 to the present were evaluated within 14 days of the onset of visual loss and followed for up to 4 years. Visual acuity change was considered significant if there was a change of 2 lines of acuity or more from baseline. Visual fields were performed to Goldmann perimetry. Expansion of 20 degrees or more was considered significant. Results: Seven patients (46.6%) had either improvement of fields or acuity or both during follow-up (acuity=4, fields=5, both=2). Improvement occurred in patients that received prednisone only and in patients receiving I.V. methylprednisolone followed by prednisone. Visual improvement when it occurred was usually within 8 weeks. One patient had worsening fields and acuity despite aggressive corticosteroid therapy. Conclusions: There does appear to be the potential for at least some visual recovery in optic neuropathy due to temporal arteritis. It may be important to conduct prospective studies to evaluate if the level of recovery can be enhanced with specific treatment strategies such as high dose I.V. corticosteroids or methotrexate.