Historically the first line of treatment for infantile hemangiomas (IHs) has been oral corticosteroids, but because of recent discoveries recognizing the effectiveness of oral and topical beta-blockers, IH management is dynamically changing. With these new treatment options, some physicians are altering the way they manage IHs despite having little evidence-based data on the treatment methods. Highlighting treatment changes at a single large tertiary pediatric referral center, we conclude that despite the numerous studies already published on this topic, more reliable prospective studies are needed to determine the safety, efficacy, and best treatment algorithms for the use of topical and oral beta-blockers for the treatment of IHs.