The range of neuro-ophthalmologic signs in temporal arteritis is broad and includes diverse presentations of ischemic optic neuropathy, retinal infarction, transient ischemic phenomena, ophthalmoparesis, pupillary autonomic and anterior ocular segment dysfunction, cortical blindness and associated post-chiasmal field defects, and complex visual hallucinations. Neurovascular compromise can follow arteritic lesions at multiple neuroanatomic sites, and reflects different pathogenetic mechanisms and displays distinctive clinical features. A variety of temporal clinical profiles and differential responses to corticosteroids occur. This article reviews the broad range of neuroanatomic pathways affected by diverse and potentially interactive etiologic factors in this systemic arteritis.