Multiple pulmonary arteriovenous fistulas were demonstrated angiographically in 8 patients who exhibited cyanosis and polycythemia during childhood. Cyanosis was first observed during infancy in 5 patients. The diffuse (telangiectatic) type was present in 2 cases, while the remainder were of the multiple discrete type with one or two dominant fistulas. The clinical and angiographic features and surgical implications of multiple pulmonary arteriovenous fistulas in these children and those reported previously are discussed.