Vascular lesions are abnormalities of vascular elements that appear at birth or in infancy. Cutaneous congenital vascular lesions are the most common pediatric birthmarks and can be divided into two different categories: hemangiomas and vascular malformations. Hemangiomas tend to involute, as the child grows older while other vascular malformations tend to persist. Congenital vascular lesions are found most commonly on the head and neck and can be isolated or part of a congenital syndrome such as Klippel-Trenaunay syndrome, Sturge-Weber syndrome and others. Vascular lesions, especially on exposed sites, can cause significant psychological distress for patients and family members.