Peripheral vascular malformations encompass a wide spectrum of lesions that can present as an incidental finding or produce potentially life-or limb-threatening complications. They can have intra-articular and intraosseous extensions that will result in more diverse symptomology and present greater therapeutic challenges. Developments in classification, imaging and interventional techniques have helped to improve outcome. The onus is now placed on appropriate detailed preliminary imaging, diagnosis and classification to direct management and exclude other more common mimics. Radiologists are thus playing an increasingly important role in the multidisciplinary teams charged with the care of these patients. By fully understanding the imaging characteristics and image-guided procedures available, radiologists will be armed with the tools to meet these responsibilities. This review highlights the recent advances made in imaging and the options available in interventional therapy.Peripheral vascular malformations (PVMs) encompass a wide spectrum of lesions that can present as an incidental finding or produce potentially life-or limb-threatening complications. PVMs are relatively common within the extremities and usually confined to the subcutaneous tissues and muscles. They can have, however, intra-articular and intraosseous extensions that will result in more diverse symptomology and present greater therapeutic challenges. Any misdiagnosis can lead to inappropriate management and treatment.