This study investigates the clinical characteristics of infantile hemangiomas located in the periocular region and evaluates the effectiveness of propranolol-based medical therapy. The research was conducted between 2022 and 2026 and included 34 infants, in whom lesion localization, size, and vascular activity were assessed using clinical examination, photographic documentation, and color Doppler ultrasonography. All patients received propranolol at a dose of 1–2 mg/kg/day on an outpatient basis under cardiological monitoring. The results demonstrated a significant reduction in lesion size, blood flow velocity, and vascular activity after treatment (P < 0.05), with early initiation associated with better clinical and hemodynamic outcomes. Color Doppler ultrasonography proved to be a reliable diagnostic tool for evaluating hemangioma activity, monitoring treatment response, and guiding individualized therapeutic strategies.