Multiple reports have suggested an association between vasculitis and hematologic malignancies, but most have involved small or medium-sized vasculitides.1,2 Concurrent malignancies have been shown to exist in 7.4% of patients with biopsy-proven giant cell arteritis (GCA), with 45% being hematologic in nature.3 Although GCA and chronic lymphocytic leukemia (CLL) have been shown to exist concurrently, rarely has the temporal artery biopsy (TAB) led to a simultaneous diagnosis of CLL.4–7 In this case study, we describe the unique finding of 2 simultaneous disease processes, GCA and CLL, on TAB.