Vascular lesions represent an important subgroup of orbital abnormalities; however, there is much controversy regarding their pathophysiology and nomenclature. Attempts at resolution of some of the issues have resulted in changes of names of some of the lesions (e.g., lymphangioma to venolymphatic malformation). Imaging plays an important role in delineation and characterization of these lesions. A radiologist informed about the pathophysiology and attentive to the internal architecture of the lesions shown on images, particularly MR images, often can predict the histologic diagnosis. Imaging information helps clarify some of the controversies surrounding these lesions.