Lymphatic malformations (LMs) are benign vascular lesions that can cause significant morbidity. This retrospective study evaluates the effectiveness and safety of intralesional bleomycin sclerotherapy in 15 patients with LMs. Patients (age range:1.5–23 years) with macrocystic, microcystic, or mixed LMs were treated with ultrasound-guided bleomycin injections. Treatment response was assessed clinically and radiologically, with outcomes graded as complete resolution, partial regression, or no response.

Results demonstrated a high response rate, with 100% of patients achieving significant volume reduction (>50%) and 20% showing complete resolution. Minor complications, such as localized swelling or transient fever, were observed but no major adverse effects and no death were reported. Bleomycin sclerotherapy proved to be a safe and effective treatment for LMs, particularly in macrocystic subtypes, offering a minimally invasive alternative or prior to surgery.