Hemangiomas are the most common neoplastic growth affecting the pediatric airway. The expected natural history includes a period of rapid growth followed by spontaneous involution. These patients often require treatment of the hemangioma in order to avoid the consequences of airway obstruction. In contrast, vascular malformations do not undergo spontaneous resolution. The clinical course and treatment options for children with vascular malformations are quite different from those with hemangioma. The clinical presentation, evaluation, management options, and expected outcomes for both of these lesions are discussed in this article.