Background: Temporal arteritis is a very serious form of vasculitis. Early treatment is essential to avoid blindness. Surgical biopsy of the temporal artery is the gold standard for the diagnosis, but facial nerve injuries may occur. Objective: To describe a simple and safe procedure for temporal artery biopsy. Methods: Case report. Results: A 62-year-old-woman with presumed temporal arteritis was referred. Precise localization of temporal arteries and its branches was obtained with color duplex ultrasonography. Arterial wall thickening (halo sign) was observed in the affected arterial segments. A frontal branch was precisely localized and infiltrated with 1\% lidocaine. About 1 cm was removed for histopathologic examination. Thirty minutes was required to perform this outpatient procedure. The diagnosis of temporal arteritis was confirmed, and the patient was rapidly and successfully treated with prednisone. Conclusions: Color duplex ultrasonography allows precise localization of temporal arteries and its branches. This echocardiography-guided surgical procedure is easy and safe. Most dermatologic surgeons can perform it.