The field of vascular anomalies is confusing because numerous types of lesions exist, different anomalies often look similar, and imprecise terminology commonly is used. Pharmacotherapy is effective for certain vascular tumors; sclerotherapy generally is the primary treatment of problematic lymphatic and venous malformations. Arteriovenous malformations remain difficult to manage because of their high progression and recurrence rates. Propranolol has gained popularity recently for the treatment of problematic infantile hemangioma, but its efficacy and safety compared with corticosteroid therapy have not been studied. Continuing education is needed to increase the use of accepted biologic terms to describe vascular anomalies; this will improve patient care and facilitate research. As vascular anomalies centers continue to develop, children will have easier access to interdisciplinary expertise. Patients are most likely to be diagnosed and treated properly when managed by a specialist or team focused on these conditions. Recent insight into the etiopathogenesis of infantile hemangioma and vascular malformations may lead to novel therapies for these lesions in the near future.