Vascular tumors of intermediate malignancy encompass a broad range of histologic entities. They are characterized clinically by having a high risk of local recurrence and limited risk of regional or distant metastasis. Vascular tumors of intermediate malignancy frequently present in the skin and often cause diagnostic difficulty. This article reviews the clinical and histologic features of kaposiform hemangioendothelioma, epithelioid hemangioendothelioma, Dabska tumor, retiform hemangioendothelioma, composite hemangioendothelioma, and epithelioid sarcomalike hemangioendothelioma. The differential diagnosis of these entities is discussed.