Cutaneous vascular anomalies have always posed a challenge to physicians of different specialties; therefore the need of a clear and reliable classification is crucial. Based on the work of Mulliken and Glowacki in 1982, a biological classification was introduced. This classification divides vascular anomalies into two categories; vascular tumors, and vascular malformations. Vascular tumors (of which hemangiomas are the most common) are those anomalies that are cellularly dynamic. Hemangiomas are characterized by a very unique course of natural history: neonatal rapid proliferation, followed by a plateau phase, then involution. In addition, various biological markers of hemangiomas have been identified. Vascular malformations are cellularly adynamic. According to the flow they can be further subdivided into high and low-flow lesions. High flow lesions are the arteriovenous malformations. The low flow malformations are categorized according to the type of vessel into capillary, venous and lymphatic malformations.MRI is the most valuable tool in imaging if vascular anomalies. Ultrasound is considered a preliminary tool for screening of the anomalies. Treatment of the anomalies depends on the type of anomaly. Hemangiomas are usually followed up, only treated in cases of complications either medically, laser or surgery. Vascular malformations require treatment. Lasers, sclerotherapy and surgery are the main lines of treatment. A multidisciplinary approach is better adopted in treatment to ensure better outcome.