Objective To determine the safety and efficacy of direct percutaneous puncture sclerotherapy in the management of venous malformations in the head and neck.Methods Nine consecutive patients with venous malformations of the head and neck underwent ethanol sclerosis via direct percutaneous puncture.Results The primary success rate was 100%.The symptoms disappeared or alleviated obviously in 7 patients after the treatment.During the follow-up from 2 to 12 months,neither vascular recanalization nor neovascular recruitment phenomenon was observed in any patient.Conclusion Ethanol sclerosis via direct percutaneous puncture is a safe and effective treatment for venous malformations in the head and neck.