Vertebral hemangiomas (VH) are primary, benign, vascular bone tumors of spine. They are generally asymptomatic and were coincidentally diagnosed. VH`s have been commonly occurred at fifth decade, even if they can be seen at any age including pediatric age-group. VH`s frequently settled on vertebral body of thoracic and/or lumbar spine. They can be classified as typical, atypical and aggressive. Aggressive type of them can cause pain and/or neurological symptoms. VH`s can be diagnosed by CT and MRI in which checked for investigating of trauma, tumor or non-specific back pain. The observation is an enough treatment modality while coincidentally and asymptomatic situation. Nevertheless, VH`s must be treated when they caused severe pain, compression on spinal cord and/or nerve root, fracture. Treatment modalities include minimally invasive techniques, surgical removing, radiotherapy and chemotherapy that can be combined but should be separately planned for each patient.