Seven cases of spindle cell hemangioendothelioma, a recently described vascular neoplasm, are presented. The lesions were multiple in five of the seven cases and primarily involved the upper extremities, particularly the fingers. On microscopical examination, the tumors were composed of two elements: cavernous spaces and spindled cells. In addition, clusters of histiocytoid endothelial cells, some with intracytoplasmic vacuoles, were present. The clinical behavior is marked by numerous local recurrences and slow but steady progression of the disease.