Hemangioma is a true vascular tumor, which is an embryonic benign tumor characterized by the proliferation of vascular endothelial cells. The incidence of hemangioma in newborns is 1.1% ~ 2.6%, and it often appears in the neonatal period, then enters the proliferative phase, stops growing around one year of age and enters the slow regression phase, and 50% of children can completely regress within 5 years of age. However, some of the large hemangiomas may leave loose and sagging skin, pigment changes and superficial scarring even after complete regression. Vascular malformations are present at birth in 90% of cases, but may have no clinical signs and grow proportionally with age and do not resolve on their own. The original traditional classification defined wine stains, cavernous hemangiomas and trapezius hemangiomas as vascular malformations are now called capillary, venous malformations and arteriovenous malformations, respectively. The main point of differentiation between hemangiomas and vascular malformations is the medical history. Children with hemangioma have a natural course of rapid growth, stabilization and regression, with growth rates far exceeding the child’s growth ratio, whereas children with vascular malformations do not have this characteristic course; in addition, serum estradiol levels and vascular endothelial growth factor are higher in children with hemangioma than in children of normal age, so diagnosis is not difficult. However, it is sometimes difficult to differentiate between venous malformations that are mildly dilated at birth and subcutaneous hemangiomas, and the diagnosis can be confirmed by experimental hormone therapy and further follow-up. Diagnosis and treatment Treatment of hemangiomas requires different treatment approaches depending on the course of the disease. Generally speaking, except for laser treatment which can be considered for pinpoint lesions, children in the proliferative stage should adopt various measures that can effectively control further proliferation of hemangioma, such as systemic hormone therapy, local hormone injection, and isotope dressing, etc. This can maintain the lesions at a relatively low level of deformity and enter the stable stage, and also reduce the difficulty of regression and alleviate the posterior deformity of regression. The stable phase can be followed up and waited for or local application of Pingyangmycin etc. to make it enter the regression phase earlier. Children in the regression phase can take appropriate treatment according to the regression situation and parents’ wishes, and the main focus of this phase is to improve the appearance. During the development of the disease, we should avoid using overly aggressive and non-selective treatments as much as possible to avoid leaving permanent and irreversible sequelae to the child. Vascular malformations are treated according to their type. Capillary malformations, or wine stains, are usually found on the face, limbs and other exposed areas, and in some cases, the lesions may become locally dilated nodular lesions in adulthood, or apparently grape bunch-like lesions, which seriously affect the physical and mental health of patients. The previous treatments including freezing, isotope patching, tattooing, drug injection, skin grinding, Chinese medicine patching, excisional implantation and laser non-selective photothermal treatment have not achieved the real cosmetic treatment effect and are gradually replaced. At present, the appropriate treatment for wine discoloration includes laser selective photothermal action or intense light treatment, photodynamic treatment and plastic surgery. Selective photothermal action laser treatment is the main treatment method at home and abroad, which is easy to operate, safe to treat, less complications and shorter treatment process, but it only has good curative effect on more superficial lesions, and the color is less uniform after fading, and it is suitable for small and scattered lesions. Photodynamic therapy is another important treatment method, which is more suitable for large, unexpanded lesions. It has a relatively small number of treatments, natural and uniform color after lesion fading, no long-term pigmentation changes, and a very low incidence of scarring, but the strict light avoidance for nearly one month after treatment and the high requirements for treatment experience have affected its rapid promotion. However, it is still considered as a future direction for research and treatment of wine discoloration. For those lesions that are accompanied by severe pigmentation changes or scarring after other treatments, or that have dilated in a nodular or grape bunch-like pattern, surgical plastic surgery is the ideal choice. Venous malformations are the most common type of vascular malformation and consist of dilated veins of varying size. As the original dilated veins expand further with age, the underlying malformed veins begin to gradually expand. Nd:YAG laser treatment is suitable for the more superficial mucosal lesions, and the mucosal repair is fast after treatment, even if there is scar formation, it rarely affects the aesthetics. For limited, low reflux venous malformations simple embolization and drainage venous sclerotherapy can achieve good results, for high reflux venous malformations need embolization and drainage venous sclerotherapy combined with surgery and other comprehensive treatment. Sclerotherapy with anhydrous ethanol, pinyamycin or a combination of both is preferred. For large range of venous malformation such as involving one limb or even trunk, it is the current clinical treatment problem. In addition to physical conservative treatment, only phased treatment and comprehensive treatment can be used to control the progression of the disease. Although sclerotherapy has the limitations of more frequent treatment, recurrence, and difficulty in eradication, surgical treatment alone also cannot solve the problems of eradication, recurrence, and aesthetics, and may even accelerate the progression of the lesion by upsetting the abnormal hemodynamic balance. For patients with significant malformations, appropriate systemic plastic surgery can be performed to improve the patient’s quality of life, provided that the disease is effectively controlled. Arteriovenous malformation is a high-flow vascular malformation that consists mainly of a direct anastomosis of dilated arteries and veins. The clinical presentation is characterized by an audible murmur in the area of the lesion, arterial pulsation and increased skin temperature. Digital subtraction angiography (DSA) and 16-row spiral CT angiography with three-dimensional reconstruction (CTA) are necessary adjuncts prior to treatment to show the arteries and draining veins supplying the malformed vascular mass, the extent of the lesion, and the relationship to surrounding tissues. Arteriovenous malformations can be divided into resting, dilated and decompensated phases. The resting phase is generally treated by interventional embolization; the dilated phase can be considered surgical treatment, surgical treatment after interventional embolization and interventional treatment alone; the decompensated phase is mainly treated surgically, and preoperative interventional embolization can be used as an adjunct to control bleeding to ease the surgery. For patients with obvious deformities in appearance, appropriate systemic orthopedic treatment can also be done to improve the quality of life of patients under the premise of safety. In view of the pathological basis of arteriovenous malformations and the abundant collateral circulation, the current view is that traditional ligation of the main supply vessels is not effective and should be avoided because of the ease of recurrence after surgery and the possibility of increasing the difficulty of subsequent treatment.