Performing both diagnostic angiography and endovascular treatments in infants and neonates may be a challenge. The choice of materials represents one of the major difficulties. We present two cases of newborns and one of an infant in which an on-the-wire microcatheter with hydrophilic coating was used without any guiding catheter nor sheath in the management of three different pathologies. A 24 gauge cannula, a 0.014-inch micro-guidewire and a hydrophilic-coated wire-directed microcatheter (Tracker Excel 14, Boston Scientific/Target Therapeutics, Freemont, CA, USA) where the only tools used to perform angiographies and subsequent treatments. One of the patients had a rapidly growing facial haemangioma resistant to medical therapy. One had a posterior cranial fossa pial fistula and another had a vein of Galen malformation.