Pediatric vascular anomalies, including hemangiomas and lymphatic, venous, and arteriovenous malformations, benefit from advanced clinicogenomic classification. Genomic insights reveal specific pathways, transforming treatment strategies. For example, Alpelisib targets PIK3CA-related overgrowth spectrum, while Sirolimus is effective for lymphatic malformations. Case studies demonstrate how these targeted therapies enhance personalized care and improve outcomes. This talk will explore the integration of genomic data in clinical settings, highlighting emerging technologies and novel therapeutic targets. Let us see how these advancements are revolutionizing pediatric vascular anomaly management through precise, genome-informed approaches.