A six-day-old female neonate weighing 3.5 kg was born at 38 weeks of gestation to a 22-year-old multigravida mother by vaginal delivery at a tertiary hospital. The mother was in good health during pregnancy and did not receive any teratogenic drugs or radiation. The baby had no history of trauma or surgery. The parents were third-degree relatives, which denoted parental consanguinity. The infant was admitted to the Neonatal Unit of the Pediatric Department due to skin lesions, bleeding, and jaundice. On general physical examination, lethargy, a rectal temperature of 34.9ºC, a respiratory rate of 68/min, a heart rate of 170/min, blood pressure of 50/30 mm Hg , an unpalpable radial pulse, a capillary refill time (CRT) of four seconds, cold extremities, weak primitive reflexes, yellowish skin up to the palms and soles, pale conjunctivas, and an oxygen saturation of 74% were detected. On local physical examination of the left leg, there were three skin lesions that were present from the time of birth. A large, blue-red-colored lesion with a length of 14cm and a width of 8 cm was visible on the left anterolateral thigh up to the middle of the calf. The surface of the lesions had a coarse and nodular appearance with pale-pink halos (Figure-1). The other two smaller skin lesions with the same characteristics were observed on the dorsum of the left foot (Figure-2). On admission, bleeding was observed from a ruptured nodular telangiectasia of the large skin lesion that had started three hours before her arrival at the hospital. Blood investigations revealed a hemoglobin of 9 gm/dl, a total leucocyte count of 9000/mm3 (polymorphs 45%, lymphocytes 50%, eosinophils 2%, monocytes 2% and basophil 1%), a red blood cell count of 2.8 million/ mm3 (mean corpuscular volume of 91.8fl, mean corpuscular hemoglobin of 35.8 pg), a platelet count of 317000/mm3, a reticulocyte count of 2%, a C-reactive protein of 0.4mg/dl, a blood sugar of 89 mg/dl, a total bilirubin of 16mg/dl, indirect bilirubin of 15 mg/dl, a baby blood group of ARh positive, and a mother blood group of ARh positive. Prothrombin time, INR, activated partial thromboplastin time, alanine aminotransferase, aspartate aminotransferase, and thyroid and renal function tests were within normal limits. Abnormal clinical findings such as tachypnea, tachycardia, hypothermia, hypotension, a prolonged CRT, an unpalpable radial pulse and cold extremities, as well as a history of bleeding from the large skin lesion for three hours, were used to diagnose hypovolemic shock. Neonatal anemia and indirect hyperbilirubinemia were diagnosed according to low blood hemoglobin and high indirect bilirubin, respectively. Initially, the patient was given 35 ml of intravenous normal saline during the first 20 minutes, oxygen therapy, and a local dressing to stop bleeding. This was followed by the administration of a 70 ml fresh blood transfusion during the next hour for the management of hypovolemic shock and bleeding. After the management mentioned, the baby became stable with normal vital signs and enough breastfeeding. On the second day of admission, doppler ultrasonography of the skin eruption and a second blood investigation were advised. The longitudinal and cross-sectional images of doppler ultrasonography demonstrated superficial fast-flow vasculature within the skin lesions (Figures -3 and 4). Congenital hemangiomas were diagnosed by the presence of typical skin lesions and doppler ultrasonographic findings in the baby. The second blood investigation revealed normal parameters except a hemoglobin level of 11.5 g/dl with normocytic normochromic red blood cells, and a total bilirubin level of 16.5 mg/dl which denoted neonatal anemia and hyperbilirubinemia, respectively. On the third day of admission, petrolatum ointment was applied to the surface of the lesion three times daily to prevent ulceration, as well as propranolol (7 mg) and iron sulfate (8 mg) twice daily were given orally to treat hemangiomas and neonatal anemia, respectively. As indirect hyperbilirubinemia of 11 mg/dl lasted up to the age of 17 days and was not severe, it was accepted as prolonged neonatal jaundice, and was managed by increasing the frequency of breastfeeding, but there was no indication of phototherapy in the index neonate. The hemangiomas did not regress or progress during the first four weeks of life (Figures -5), hence, they were diagnosed as noninvoluting congenital hemangiomas. The surgical indications for CH include tumor sites with higher death rates and lesions that persist until pre-school age. Therefore, such management was not carried out in the index case.