The authors report their experience with percutaneous image-guided sclerotherapy for treatment of unresectable lymphangiomas. Five patients with unresectable lymphangiomas of the pelvis (n = 2), neck (n = 1), abdomen (n = 1), or leg (n = 1) were treated at two medical centers with sclerotherapy, with use of doxycycline as the sclerosant. Computed tomography was used to guide the procedures, with supplemental lymphoscintigraphy, ultrasound, and magnetic resonance imaging used as needed. Symptomatic relief of lymphedema, lymphorrhea, or a decrease in size of lymphatic pools was achieved, to varying degrees, in the five patients. Follow-up is ongoing, and further sclerotherapy may be indicated as the clinical course dictates. Percutaneous sclerotherapy with doxycycline is safe and appears effective for palliative treatment of unresectable lymphangiomas on the basis of our initial clinical experience.