Hemangioma in the orbital area not only affects the appearance but also adjacent to the eye. In severe cases, the fast-growing tumor can obscure the visual axis or compress the eye, affecting the development of infants and children’s eyes, leading to serious complications such as amblyopia and strabismus, and the treatment can easily lead to risks such as malformation and blindness. Based on the history, examination and MRI most of the hemangiomas are clearly diagnosed; we have explored different treatment methods for twenty years including: 1, interstitial injection therapy: a mixture of methotrexate and methotrexate with 1% lidocaine containing Depo-Provera, is injected directly into the interstitial stroma by puncture. 2. surgical resection; 3. oral hormone; 4. interstitial injection therapy combined with oral hormone; 5. interstitial injection combined with surgery as well as oral hormone; 6. oral propranolol; 7. interstitial injection with oral propranolol. Findings: Interstitial injection combined with oral propranolol treatment, the tumor basically subsided and the eye opening returned to normal. The tumor stopped growing and mostly regressed. Conclusion: Most severe infantile hemangiomas in the orbital area grow rapidly, affecting appearance and ocular development, and should be treated as early as possible. Combination therapy such as, interstitial injection, surgery, interstitial injection combined with oral hormone or propranolol can be used. Interstitial injection combined with oral propranolol can rapidly control the rapid growth of the tumor, and its less invasive, reliable efficacy, less side effects, and good morphological and functional recovery make it the treatment of choice for severe infantile hemangiomas in the orbital area. Of course, the treatment must be carried out by experienced doctors and regular hospital visits.