Pediatric hemangiomas and vascular malformations are a group of common diseases, mostly found in the skin and subcutaneous tissues, followed by oral mucosa and muscles, with an incidence of 0.3-1%, three times more common in female than male infants. Most of the children with hemangiomas and arteriovenous malformations have their appearance as the main problem, but in a few cases, the lesions are too large and deep and involve important organs. Most hemangiomas and vascular malformations can be recovered with effective treatment, but in a small number of cases, serious complications or severe hemodynamic abnormalities occur, which not only make conventional treatment difficult, but also have the potential to be life-threatening. Hemangiomas and vascular malformations of the head and neck are more prone than other sites to secondary rupture, infection, tissue loss and ultimately scarring that can last a lifetime. After a period of rapid proliferation, the growth of hemangiomas stabilizes and grows in parallel with the child. Due to the complexity of hemangioma biology, the proliferative phase can continue while the melanotic phase slowly begins and gradually becomes dominant. In melanotic hemangiomas, the endothelial cell composition gradually decreases and is replaced by fibrofatty deposits, and the basement membrane shows a monolayer and normal mast cell counts. In other cases, early intervention is needed for the following reasons: 1. Although hemangiomas generally start with punctate lesions, there are two rapid growth processes in their natural course (1-2 months and 4-5 months after birth, respectively), during which the lesions develop rapidly and the damage of the lesions is unpredictable, and if early intervention can be made, it is possible to stop them from entering the rapid growth phase. The most serious consequences are those involving the pharynx and trachea. If not treated actively with laser or tracheotomy, the patient may have difficulty breathing or even die due to airway obstruction; 3. Large skin hemangioma can also lead to skin ulceration, necrosis, secondary infection, etc., which can cause a series of care problems; 5. Disfigurement can lead to various psychological problems, such as low self-esteem, isolation, paranoia, decreased self-confidence, etc.; 6. There is a lack of objective indicators for determining the degree of final regression of hemangioma. Therefore, infantile hemangiomas should be actively controlled and intervened at an early stage, unless they occur in hidden areas that do not lead to functional disorders, and only then can follow-up observation be considered. Clinical manifestations of pediatric hemangiomas and vascular malformations Most arteriovenous malformations and hemangiomas appear around one month after birth, and infants tend to develop more rapidly around the age of 2 years, with rapid increase in lesion size and volume, and come to the doctor. Some hemangiomas are visible at birth, initially as a mosquito bite like red spot, then grow rapidly and increase in size and thickness faster than the body growth rate. Those that do not rise above the skin and have a large area are called “wine spot hemangioma”, while those that resemble prunes above the skin surface are called “prune-like hemangioma”. There are also deeper “cavernous hemangiomas” and “grape hemangiomas”. Later in life, arteriovenous malformations (AVMs) are subcutaneous dark red, blue or purple lesions consisting of blood-filled sinuses and thin-walled veins, ranging in size from 1 mm to 30 mm in diameter, which do not recede when pressed, but there are also deep lesions involving the skin, and the location and extent of the lesions are not characteristic. Craniofacial soft tissue arteriovenous malformations are mainly manifested as ill-defined soft tissue bulges with normal skin color, or with dilated capillaries or dark red, with dilated light blue veins underneath. Some children with arteriovenous malformations and hemangiomas have increased skin temperature, palpable pulsation, and a blowing murmur on auscultation. A detailed history should be taken from the family and a careful physical examination of the lesion and the child’s whole body should be performed to gather as much evidence as possible for the diagnosis.