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ascular malformations of the head and neck region can cause cosmetic and functional disturbances. These may lead to enormous psychosocial problems for patients and their families affecting activity of daily living. We present an unusual case of large low flow vascular malformation of left cheek and upper part of neck, involving left pterygopalatine fossa and left para-pharyngeal space. Our case demonstrates the effective management by combined intra-lesional sclerotherapy of injection Bleomycin and injection Sodium tetradecyl sulphate. Multi Detector Computed Tomography (MDCT) played an important role in determining the extent of lesion, feeding vessels, nature of lesion and also in tailoring the management of vascular malformations.