Arteriovenous malformation (AVM) is a congenital vascular malformation that can occur in various locations such as intracranial, pulmonary and superficial soft tissues. AVMs have a flushed appearance with elevated skin temperature and sweating. Pulsations can be palpated at the nutrient arteries and a persistent murmur can be heard on auscultation. The diagnosis can be confirmed by ultrasonography, MRI, CTA, DSA, etc. The risks caused by AVM include: cosmetic damage, rupture and bleeding of the tumor, local tissue hypertrophy, invasion of local muscle and bone which may lead to limb disability, ischemia and necrosis of the distal limb, high-flow heart failure, etc. The treatment of AVM includes surgery, interventional therapy, embolization and sclerotherapy, and copper wire placement. For AVM with clear boundary and limited scope, surgical resection is feasible. For extensive AVM involving vital tissues and organs, interventional treatment is the only option. Copper wire placement is suitable for AVMs at the end of the limb. Injection of anhydrous ethanol into AVMs under DSA is considered one of the most effective methods of interventional embolization therapy. Anhydrous ethanol is intensely destructive and injection of anhydrous ethanol into the AVM lesion will completely destroy the AVM’s nutrient arteries, arteriovenous fistula masses and refluxing veins. Treatment is rapid and complete. Accurate and adequate treatment of AVM with anhydrous ethanol is very effective. Of course, when performing interventional embolization treatment it is important to precisely inject anhydrous ethanol as in the AVM to avoid ectopic embolization. This needs to be done by an experienced orthopedic surgeon and interventional surgeon under clear DSA images. The following is our case of anhydrous ethanol embolization under DSA for intramuscular AVM. Case: A 37-year-old male patient with a left gluteal AVM in the gluteus maximus muscle that had been treated surgically and failed. Pre-treatment appearance, DSA images and MRI images. The AVM lesion had shrunk significantly, and the DSA showed that there was still a small lesion, so we performed a second treatment.