Current histologic and immunophenotypic criteria useful in the pathological diagnosis of benign vascular tumors and anomalies of childhood, with emphasis on infantile hemangiomas and vascular and lymphatic malformations, have been described and correlated with clinical presentation. The authors have emphasized recent advances in research that portend an emerging revolution in our understanding of these perplexing lesions. These latter findings, particularly in the case of hemangiomas, suggest possible new preventive strategies and therapeutic avenues involving targeted use of angiogenic modulators.