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A retrospective analysis of a prospectively collected lymphatic malformation data base was performed that included 16 patients (5 males, 11 females; mean age, 15 years; range, 1=47 years). Patients with at least 1 microcystic lymphatic malformation component demonstrated on MR imaging treated by lymphographic-like technique bleomycin infusion were included in the study. Patient interviews and MR imaging were performed to assess subjective and objective clinical improvement (microcystic lymphatic malformation size decrease of >30%). The authors observed no major and 3 minor complications: 1 eyelid infection, 1 case of severe postprocedural nausea and vomiting, and 1 case of skin discoloration. MR imaging objective improvement was observed in 5/16 (31%) patients; overall improvement of clinical symptoms was obtained in 93% of treated patients. Bleomycin lymphographic-like technique for microcystic lymphatic malformations was safe and feasible with objective improvement in about one-third of patients.