The treatment of venous malformation is a hot research topic in recent years, and there are various treatment methods, including surgical excision, laser irradiation, sclerotherapy, etc. 1.Surgical resection has a lot of bleeding, not easy to control, poor visual field, and some cannot be completely eradicated. If we want to protect important tissues for palliative resection, the residual hemangioma and abundant anastomotic vessels are prone to recurrence. If the hemangioma is completely removed, it will be traumatic and easily lead to local deformity, which also affects the appearance and function and is difficult to repair. 2.Laser irradiation has limited penetration depth and is suitable for treating superficial lesions, but is not effective for huge and deep tissue venous malformations. 3.Sclerotherapy of venous malformation, due to the advantages of simple treatment, fast onset, no local trauma, no necrosis, no scarring and repeatable injection, no obvious side effects, etc. is being promoted. At present, the commonly used sclerosing agents are mainly anhydrous ethanol and pinyamycin. The treatment mechanism of anhydrous ethanol for venous malformation is that its dehydration and exfoliation effect denatures hemoglobin and destroys endothelial cells of blood vessels, which rapidly causes necrosis and thrombosis of lesions, and through the formation of blood clots, necrotic tissue and inflammatory tissue are formed in the vessel wall, and gradually scar fibrosis increases the fibrous connective tissue of the vessel wall, leading to collapse and closure of the vessel wall and gradual reduction of lesions. Pingyangmycin is an anti-tumor antibiotic screened from 15 kinds of Bleomycin components produced by Streptococcus Pingyang (SP). Its composition is similar to Bleomycin A5, and its mechanism of action is to inhibit DNA synthesis and cut off DNA strands, which can affect the metabolic function of blood sinusoidal endothelial cells after local injection, causing them to degenerate and necrosis and form fibrosis, and eventually make the lesions gradually decline and heal. At present, anhydrous alcohol + iodinated oil emulsifier and pinyamycin + iodinated oil emulsifier are mostly used. Mixing anhydrous ethanol with iodized oil reduces the concentration of ethanol and alleviates the toxic reaction of ethanol on the one hand; on the other hand, iodized oil can prolong the retention time of ethanol in the blood vessel, thus strengthening the effect of anhydrous ethanol embolization, while anhydrous ethanol can delay the clearance of iodized oil in the lesion, thus the two have synergistic effects. In addition, iodinated oil has the property of contrast agent, which is convenient for monitoring embolization process under X-ray and follow-up observation. The drug potency of pinyamycin remains unchanged when mixed with iodinated oil, while the emulsifier can prolong the action of pinyamycin and improve the efficacy. Before treatment of large venous malformations, a lesion lumpectomy should be performed, i.e., a contrast agent should be injected into the lumen of the malformed vein to understand the reflux status of the malformed vein. If the contrast agent remains in the lumen for 5 min after injection, it is a low reflux venous malformation; if the contrast agent disappears quickly and the retention time is less than 5 min, it is a high reflux venous malformation. The clinical observation of this study suggests that: anhydrous ethanol is effective in treating venous malformations in children, with fast onset of action and relatively fewer treatments, but with relatively greater side effects; pinyamycin is mildly effective and has relatively low side effects. For superficial venous malformations, the use of pinyamycin emulsifier has good efficacy and low side effects, and for deep venous malformations, the use of anhydrous ethanol has good efficacy. According to the imaging performance and staging of the tumor, the combination of anhydrous ethanol and pinyamycin is the future trend of the development of sclerotherapy for venous malformations.