Objective To explore the effectiveness of local bleomycin injection in the treatment of microcystic lymphatic malformations （LMs）. Methods From January 2009 to December 2013, 32 patients with microcystic LMs were treated by bleomycin injection and followed prospectively. Ultrasound examination were used to confirm the diagnosis and determine the scope and level of the cyst before bleomyein injection. Each patient received bleomyein injection at an interval of 4 to 6 weeks. Results The mean injection times was 3.5 times. Thirty cases were cured and 2 cases were partially cured. All the patients were followed up for 1-4 years. Ultrasound follow-up demonstrated no recurrence of microcystic LMs. And no drug side-effects were observed. Conclusion Local application of bleomyein in patients with microcystic LMs is a safe and effective method. Totally healing can be achieved in the majority of cases.