Vascular malformations represent a broad and complex spectrum of in part congenital and tumor-like conditions that occur either as systemic disorders or organ-specific pathologies. Hemodynamically, vascular malformations are classified as slow flow, high flow, and mixed malformations. The slow-flow disorders, Klippel-Trenaunay syndrome, Sturge-Weber syndrome, and unilateral nevoid telangiectatic syndrome, rarely involve the liver, where they manifest as abnormal vessels, mainly venous abnormalities, angiectases, and angioma-like lesions, sometimes associated with focal nodular hyperplasia or related changes. A distinct group of disorders is congenital and acquired venovenous malformations of the liver and patent ductus venosus, resulting in portosystemic shunts and associated parenchymal changes.