We have used Pingyangmycin in the early stage of hemangioma treatment in China, and achieved very good results and rich experience. Pingyangmycin is an antitumor drug extracted from Streptococcus pingyangensis, which is used as a sclerosing agent for local injection to treat hemangiomas and venous malformations. Its mechanism of action is to inhibit the proliferation of vascular endothelial cells and make the hemangioma subside. Since the thrombosis in the lumen and the inflammatory reaction outside the lumen caused by it are less obvious than that of sodium cod liver oil acid, the reaction such as local swelling and pain is lighter in clinical practice. It can be used for patients with hemangiomas that are poorly treated with steroids, those who are older than the natural regression period of hemangiomas, and venous malformations, lymphatic vascular malformations and mixed malformations. Pingyangmycin has adverse effects and certain risks in the treatment of hemangiomas, venous malformations and lymphatic vascular malformations. After 30 min of administration, the local tissues are mildly swollen; after 24 h, the swelling and pain increase, the degree of which is related to individual differences and the injected dose. 2-3 days later, the swelling begins to subside and the pain is relieved, after which the tissues gradually harden and the skin and mucous membrane become white in color; after 2 weeks, the color gradually becomes normal; after 2-3 months, the tissues gradually return to normal. The most serious adverse reaction of Pingyangmycin is anaphylaxis (2 cases have been reported in the literature), which occurs rapidly and suddenly and can lead to death; other common adverse reactions include fever, mostly at 38.5℃-39.5℃, which usually subsides with symptomatic treatment; gastrointestinal reactions manifesting as anorexia and poor appetite; local rupture, temporary small amount of hair loss, skin reactions (nail darkening, skin itching), local necrosis. The reaction of the gastrointestinal tract is usually resolved with anorexia and poor appetite. When Pingyangmycin is used intravenously, the main adverse reactions are febrile gastrointestinal reactions (nausea, vomiting, lack of appetite, etc.), skin reactions (hyperpigmentation, keratinization thickening, dermatitis, rash, etc.), hair loss, limb paresthesia and oral inflammation. Before treatment, we should show the situation and do relevant examination, pay attention to the history of drug allergy, and apply drugs to prevent and reduce febrile reactions. For infants and children with hemangioma, the aim should be to control the development of lesions and wait for the remission period before further treatment. Since Pingyangmycin is an antitumor drug, high dose application can cause pulmonary fibrosis and in vitro test has a high teratogenic rate. The dose, concentration and treatment interval of local injection should be strictly controlled to avoid complications such as local tissue ulceration, necrosis, pigmentation and local tissue atrophy.