In 1982, Mulliken proposed a new classification based on the pathological characteristics of vascular endothelial cells and divided congenital vascular lesions (collectively referred to as hemangiomas in China) into two categories: hemangiomas belonging to true tumors and vascular malformations with abnormal development. The two are significantly different in terms of pathogenesis, clinical manifestations, prognosis and treatment. Hemangiomas are characterized by the biological characteristics of vascular endothelial cell proliferation and growth, while vascular malformations are abnormal expansion and communication of capillaries, veins or arteries, which are the tissue structure and biological characteristics of normal endothelial cells, which are in a resting state. Depending on the type of vessels contained, they are classified as capillary malformations, venous malformations, arteriovenous malformations and mixed vascular malformations. The incidence is lower than that of hemangioma and can occur in all parts of the body, with the head and neck being the most common, followed by the limbs and trunk, and also in important tissues and organs such as bones, internal organs, and the brain. Unlike hemangiomas, which are more common in females, vascular malformations do not differ by gender and most of them are present at birth. The lesions develop gradually throughout life with age and have no tendency to fade on their own. The clinical presentation varies depending on the type and location of the vessels included in the lesion. Capillary malformations are commonly known as wine stains. It occurs mostly on the skin of the face and is often distributed along the trigeminal nerve distribution area. It is bright red or purplish red, flat with the skin surface and clearly circumscribed. Its shape is irregular and its size varies, from small spots to several centimeters, and large ones can extend to one side of the face or cross the midline to the opposite side. When the lesion is pressed with a finger, the surface color recedes; after the pressure is removed, the blood immediately fills the lesion again and the original size and color are restored. If the venous malformation is deep, the skin or mucosa is normal in color; superficial lesions appear blue or purple. The borders are not well defined and are soft enough to be compressed, and sometimes venous stones can be found. When the head is in a low position, the lesion area is filled with blood and swollen; when the normal position is restored, the swelling is also reduced and restored to its original state, which is called a positive postural shift test. Arteriovenous or arteriovenous malformations, also known as trapezius hemangioma, have an elevated rosaceous appearance with a higher surface temperature than normal skin. The patient may feel the pulsation himself; there is a tremor on palpation and a blowing murmur on auscultation. If the artery supplying blood is completely closed, the pulsation and murmur in the lesion will disappear. The tumor may erode the bone at the base, or it may protrude into the skin and make it thin, or even necrotic and bleeding. The presence of more than one type of vascular malformation can be referred to as mixed vascular malformation, and the clinical manifestation is a combination of the above vascular malformation. Vascular malformations have a wide range of lesions with unclear boundaries and can invade multiple layers of tissue from the skin to the deep muscles. The location, extent, and severity of lesions vary from patient to patient. To determine the location, size, and extent, ultrasound, arteriography, lumpectomy, or magnetic resonance angiography (MRI or MRA) can be used to assist in diagnosis and as a reference for treatment. Current treatments include surgical resection, radiation therapy, hormone therapy, cryotherapy, laser therapy, sclerotherapy injection, etc. Comprehensive therapies are generally used. For vascular malformation, since its development law is lifelong development with age, and the older the age, the faster the development, so from its own development law should be treated as early as possible, but its treatment, except for capillary malformation preferred laser or photodynamic therapy, generally requires surgical resection, which requires the consideration of the patient’s tolerance for surgery, the younger the age, the less tolerance for surgery. Considering these two factors, the timing of treatment for vascular malformations is to treat them as early as possible if the patient can tolerate surgery, generally after the age of 1 year. For vascular malformation, in principle, complete surgical excision of the lesion is required to achieve the purpose of cure, but the conventional surgical excision alone has a lot of bleeding, high risk and high recurrence rate, we use local urea injection + surgical excision, and the lesion tissue is hardened by local urea injection before surgical excision, which reduces bleeding, risk and recurrence rate.