Background: Vascular anomalies are disorders of the endothelium and surrounding cells that causes localized structural defects of the vasculature. The clinical presentation of vascular anomalies is confusing because all lesions appear in the color spectrum of blue, pink, and red. The most common problem associated with vascular anomalies is psychological distress related to disfigurement as well as functional defects, as many lesions affect the head and neck. Materials & Methods: This was a prospective study conducted in the Department of Plastic Surgery, Govt. Chengalpattu Medical College & Hospital, Chengalpattu from January 2009 to January 2011. 14 patients with various vascular malformations of the head and neck were included in the study. Patients underwent either conservative management, alcohol ablation, surgical excision or a combined approach. Embolisation was not attempted due to the lack of an interventional radiologist at our institution. The outcomes were later analysed. Results: A total of 14 patients were included in the study. There were 4 males, 8 females and 2 children. One patient had conservative management, five underwent alcohol ablation (multiple sittings), six had surgical excision and two patients underwent a combined approach. All patients were followed up for a minimum period of 6 months Conclusion: Management of vascular malformations is a challenge. Haemangiomas were managed conservatively, small low flow lesions were treated by alcohol ablation, localized lesions were managed with excision and primary wound closure and large diffuse lesions were managed by a combined modality