Vascular anomalies are subdivided into two main groups: vascular malformations and vascular tumours. The important initial aspect to consider is the use of correct terminology for proper differentiation and diagnosis of vascular lesions. Infantile haemangioma is the most frequent childhood tumour benign due to its typical course: development shortly after birth in most cases than proliferative exponential growth followed by involuting stage starting after 9 to 12 months and which can last for up to 7–10 years. Epidemiological observations suggest that infantile hemangiomas are more common in females, with a greater preference for lighter skin types and have higher incidence in premature infants, especially those with less than 1500 grams of the birth weight. Despite all research efforts in this field, the pathogenesis is still not fully understood. Three main hypotheses have been proposed: the theory of tissue hypoxia, the theory of embolization of placental endothelial cells and the theory of increased angiogenic and vasculogenic activity. Evidence was found that mesenchymal cells, isolated from proliferative infantile hemangiomas are capable of differentiating into endothelial perivascular and adipogenic cells. Although infantile hemangiomas are benign and self-limiting, severe complications can arise due to localization and fast tumour growth. IH often needs no treatment but the „watch and wait“ principle is followed less often nowadays, especially after the discovery that β-blockers both orally and topically in superficial types can also play an important role in their treatment. On the other hand, infantile hemangiomas associated with complications or those without complications but with great risk of developing complications obviously require immediate systemic treatment as well as ulcerated or hemangiomas giving serious cosmetic and functional impairment. In these cases therapy is necessary. The number of studies comparing different therapies is increasing. For many years systemic options used to be corticosteroids, with low success rates and sometimes important complications. Therapy has changed considerably over the last ten years. Currently propranolol has a main role in systemic treatment due to its safety et efficacy. Pulsed dye laser is the most commonly applied modality as a part of multimodal therapy for residual lesions, superficial and ulcerated infantile hemangiomas.