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Background and Purpose: Recent data indicate that lipid peroxidation is implicated in the pathogenesis of giant cell arteritis with a close anatomic relationship between reactive oxygen species and oxidatively injured vascular tissue., Patients and Methods: Immunohistochemistry utilizing anti-ox-LDL was performed on paraffin sections of isolated temporal arteries obtained from patients (n=23) suspected of having temporal arteritis. Enrichment as well as staining intensity of ox-LDL in vascular tissue was analysed by digital image planimetry., Results: Temporal arteries with biopsy proven temporal arteritis (n=11) presented with significantly higher enrichment of ox-LDL in the intima (16.9+/-4.2% vs. 11.25+/-2.3%; p<0.01) and mean (9.6+/-2.4% vs. 6.75+/-1.8%; p<0.01) as compared to healthy controls. Comparable results for the staining intensity were found in the intimal (2.8+/-0.5 eU vs. 1.7+/-0.4 eU; p<0.01) and medial layer (1.55+/-0.5 eU vs. 1.04+/-0.6 eU; p<0.01) of diseased patients compared to controls., Conclusions: Accumulation of ox-LDL in the intimal layer, especially at the intima-media-border, was closely related to disruption of the elastica interna and adjacent vascular tissue, presumably contributing to the underlying process of intimal hyperplasia through unimpeded migration of smooth muscle and accumulation inflammatory cells.