Background: Infantile hemangioma is a congenital vascularmalformation. Although almost all cases are self-limiting, treatmentis sometimes necessary. According to previous studies, topicalimiquimod induces resolution of lesions with an acceptable safetyprofile. The aim of the present study was to evaluate the effect ofthis topical treatment on Iranian infantile hemangioma patients.Method: Patients under two years of age with infantile hemangiomawho were not candidates for immediate systemic therapy withsteroids were selected if the lesions were not ulcerated. Topical5% imiquimod was applied on the lesions for 16 weeks. All thelesions were photographed before the commencement of the studyand at the end of the treatment. Photographs were compared bytwo associate dermatology professors to evaluate the effect oftreatment using a visual analogue scale.Result: A total of 15 patients including five males (33.3%) andten females (66.7%), with an age range of two to 18 months anda mean age of 9.1 (± 6.3) months, were enrolled in the study.The mean diameter of the lesions was 2.6 cm (± 1.8 cm). Ninepatients (60%) had moderate response and five patients (33.3%)had good response while one patient had excellent response.Complications were mild local irritation and pruritus.Conclusion: It seems that topical imiquimod could be a suitableoption in the treatment of some infantile hemangioma lesions notcandidate for systemic treatment and/or other local measuressuch as laser and intra lesional steroid or when other drugs areuseless or harmful..