Giant cell arteritis is a large-vessel vasculitis occurring in patients aged 50 or over. Our aim was to describe the diagnostic and therapeutic difficulties encountered in the management of this vasculitis. We retrospectively included patients with ACG according to the 1990 ACR criteria, followed at the internal medicine department of Mohamed Tahar Maamouri Hospital, over a 5-year period. Twenty-one patients, including 16 women, were included. The mean age was 70 years. The main presenting symptoms were headache and ocular manifestations. Biological inflammatory syndrome was constant. Halo sign, external carotid stenosis, thoracic aortitis and aortic ectasia were noted in one case each. Temporal artery biopsy was contributory in 9 cases. Corticosteroid therapy was constantly prescribed and associated with methotrexate in four patients. Osteoporosis, cortico-induced diabetes and infections were the main adverse effects noted. Progression was favorable in 19 patients, while blindness persisted in two.