Vascular anomalies comprise vascular neoplasms that result from active cell proliferation and vascular malformations which are congenital defects in vascular development. The distinction between tumors and malformations was recognized by the International Society for the Study of Vascular Anomalies (ISSVA) to provide a more clinically useful classification scheme and internationally consistent nomenclature. It focuses on a systematic approach to vascular lesions that correlates predictably with clinical history, disease course, and treatment options. Vascular tumors are further classified as benign, locally aggressive (borderline), or malignant. The most common of these is Infantile Hemangioma. Vascular malformations, on the other hand, are named after the vessel type(s) that compose them, i.e., venous malformation, lymphatic malformation, arteriovenous malformation, and assorted variations. Fistulae represent related vascular pathologies. Orbital vascular anomalies present unique challenges owing to the compartment they occupy and the critical structures therein. These lesions can be classified independently of tissue type, based on flow radiographic and clinical flow characteristics.