What are the trends of hemangioma? When is the best time to treat? What method of treatment should I choose? What is the expected outcome? At present, some doctors and patients’ families still have some misconceptions about these questions. With the development of medical technology, more and more patients are diagnosed with hemangioma. This lesion has a great impact on the patient’s appearance and limb movement function, but the treatment results are often unsatisfactory, even leaving irrecoverable sequelae and adding to the subsequent problems. Overtreatment often leads to adverse consequences. The vascular system of the human body mainly includes arteries, veins, lymphatic vessels and capillaries. A group of congenital disorders resulting from abnormal development of primitive blood vessels during human embryonic development are called vascular malformations. Vascular malformations can also occur in internal organs of the body, such as the liver and the skull. Previously, people referred to all vascular lesions as hemangiomas. Modern medicine, on the other hand, classifies hemangiomas in the traditional sense into two categories, hemangiomas and vascular malformations, based on the clinical and histological characteristics of the lesions. Bright red patches high above the skin surface that resemble strawberry-like lesions with uneven heights were formerly known as strawberry hemangiomas. These hemangiomas appear at birth or a few weeks after birth, and about 60% of them occur on the face and grow rapidly within one year of age. They are characterized by a period of rapid proliferation, stabilization, and spontaneous regression. Usually the lesions stabilize after the age of 2 years, with about 10% of cases regressing on their own each year, i.e., about 50% of cases regressing by the age of 5 years, and about 70% of cases regressing by the age of 7 years. Some patients continue to regress up to 10 years of age, but may not regress completely. In many cases, the adverse outcome is not caused by the lesion itself, but by overtreatment. Therefore, most lesions can be observed clinically until they resolve on their own. Vascular anomalies that occur subcutaneously and intermuscularly are mostly vascular malformations. Depending on the composition of the lesion, it can be classified as arteriovenous malformation, venous malformation, lymphatic malformation and mixed malformation. Vascular malformations are benign lesions, but can grow in a malignant manner. Infiltration of the lesion into the intermuscular space and even into the bones and joint cavities can affect tendons, nerves and joints, resulting in limb deformity and dysfunction. Most vascular malformations grow diffusely, invading multiple groups of muscles and even joints, without an intact envelope on the surface. Surgical excision is highly invasive and difficult to completely remove the lesion, with a high recurrence rate. Excessive resection often results in permanent postoperative motor dysfunction. Vascular malformations grow in proportion to the patient’s growth and development, do not resolve on their own and develop throughout life. It is difficult to cure by one method alone. Currently, the causes of hemangiomas and vascular malformations are not well understood by modern medicine, and there is no cure. In particular, the treatment of vascular malformations with large areas or those growing in special places is still a major issue for the medical community. The many treatment methods available for hemangiomas also illustrate the complexity of hemangiomas and the difficulty of treatment from another perspective. For most cases, it is difficult to obtain a cure with one treatment method alone. The main goal of treatment is to relieve symptoms and slow down the rapid progression of the lesion. When choosing a treatment, it is most important to weigh the pros and cons of the impact on the patient. In general, cases with localized lesions and less severe clinical symptoms can be treated conservatively by applying local compression (e.g., elastic bandages, etc.) and oral propranolol to potentially delay lesion development and reduce discomfort. If the lesion is large and affects the patient’s appearance, has significant clinical symptoms, affects limb motor function and develops other serious complications, interventional treatment is required. Arteriovenous malformations that are predominantly high-flow vascular malformations should be treated first with radiological intervention to embolize the malformed blood supply artery. For the vast majority of venous malformations and lymphatic malformations, especially massive oral and maxillofacial lesions, trunk and intermuscular lesions, electrochemotherapy (also known as electroacupuncture) offers a less invasive, faster recovery and more effective option. Electrochemotherapy applies several electric needles, which are directly punctured through the skin to the lesion area and connected to an electrochemotherapy instrument for treatment. After treatment, the endothelial cells of the lesion are destroyed, the blood in the lesion area is coagulated, the compressible soft mass becomes a solid mass, the size of the lesion becomes smaller, the clinical symptoms are relieved, and the progression of the lesion is delayed. The treated solid masses are gradually absorbed by the body. Compared to traditional surgical methods, electrochemotherapy is technologically more advanced, yet the procedure is relatively simple. Different anesthesia methods are used depending on the location of the lesion. The doctor first sticks the cannula needle into the tumor, and blood is visible at the end of the needle. Then the needle core is pulled out and the platinum electro-needle is sent into the tumor along the cannula to protect the normal skin and connect the electro-chemotherapy apparatus and connect the direct current for treatment. The voltage and current used are limited to 20 volts and less than 200 mA, which is very safe for human body. During the treatment, the gas and necrotic tissue fluid generated in the lesion can be seen to flow out from the end of the cannula needle, and the lesion gradually hardens. Patients are discharged after a short period of postoperative anti-inflammatory treatment and 3 to 5 days of hospitalization for observation. Electrochemical treatment can usually be tried in patients with hemangiomas that have not been severely invaded by nerves or bone, or that have recurred after other methods of treatment. The masses do not disappear immediately after electrochemical treatment of hemangioma because it takes 3 to 6 months for the clot and necrotic tissue to be absorbed. However, because the hemangioma cavity is closed and will not grow back, most of them will not recur. Electrochemical therapy expands the indications for treatment, and avoids the disadvantages of general surgical resection, such as more bleeding, trauma, affecting the patient’s appearance, high recurrence rate and sequelae, and significantly improves the cure rate. Moreover, the hospitalization time is short, the cost is low, the trauma is small, there is almost no bleeding, the clinical effect is good, and the economic pressure on the patient is relatively small. Since 1992, the author has cured more than 800 patients, with a cure rate of more than 98%. The method was also applied to treat a case of a world-rare hemangioma in a 2-month-old child with 66 lesions throughout the body. This case was reported on Shaanxi TV and Huashang News.