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This report evaluates head and neck lymphatic malformations (HNLMs) treatment outcomes. It presents a relative risk analysis of whether delaying invasive therapy reduces treatment number and risk. Delaying treatment in grade 1 HNLMs reduces invasive treatment number, but in grade 2 malformations this strategy does not reduce number of treatments. Observation and delayed IT in stage I–III HNLM (“Grade 1”) is safe and reduces IT (i.e., ≤1 IT). Stage IV–V HNLMs (“Grade 2”) with early IT have a greater risk of multiple ITs.
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