Aims <p>Bladder vascular malformations are rare. Hence, we would like to discuss share an interesting case of a patient who presented with venous malformation in the bladder and underwent sclerotherapy.</p> Methods <p>A 4-year-old boy was referred with a history of worsening haematuria and dysuria. Ultrasound urinary tract showed a suspicious lesion in the bladder wall and hence MRI pelvis was done to characterise the lesion as well as to look for other lesions. This confirmed a low flow vascular malformation on the right supero-lateral bladder wall. It measured 10&#xa0;×&#xa0;15&#xa0;×&#xa0;6&#xa0;mm with subtle venous filling with no large draining vein suggestive of venous malformation. Under general anaesthetic, rigid cystoscopy with 9.8/8 Fr Wolf STING cystoscope was performed which showed 3 foci of exophytic bluish lesions identified as venous malformation. These were then injected with 4 ml of 3% Sodium Tetradecyl Sulphate Foam using a 3.7 Fr × 23 G Deflux needle under vision. Imminent blanching was noted and there were no complications. He had serial ultrasound examinations which showed a slight reduction in the size of the lesion with associated clinical improvement. He then went on to have a second dose of sclerotherapy at 10 months after first dose. The haematuria has resolved completely, and he is awaiting another ultrasound scan in a few months.</p> Results <p>The patient’s symptoms have improved, and a repeat ultrasound scan showed a flatter echogenic lesion with no significant internal vascularity.</p> Conclusions <p>Sclerotherapy is safe and effective for managing bladder venous malformations. Longer term follow-up is needed.</p>