Vascular malformations of the head and neck are lesions that often involve multiple contagious anatomic spaces and incase critical neurovascular structures, making surgical treatment difficult and often unsuccessful. Percutaneous and transarterial sclerotherapy have been advocated as effective alternative or adjuncts to surgery. An understanding of the pathophysiology of the lesion has removed ligation of the external carotid and direct surgical approaches from the current armamentarium.A single classification for soft tissue vascular lesions is necessary in order to decide on the proper investigation and the best treatment. MR imaging is a noninvasive imaging technique for classification and post therapy follow up of vascular malformations. CT scan or magnetic resonance imaging is best to evaluate the extent of the lesions prior to treatment. Doppler ultrasound, in high-flow malformations or hemangiomas, is the initial imaging modality for recognizing vascular tumors from vascular malformations.Digital subtraction angiography, the reference test for accurate separation of high- and low-flow lesions, gives information about the vessel supply and whether embolization is possible.Recent advances in embolization techniques including Super selective catheters, Flow control techniques, and Variety of embolization materials. The type of embolic agent used is determined by the angio-architecture of the lesion.