Femoral head necrosis is a pathological evolutionary process that initially occurs in the weight-bearing area of the femoral head, with damage to the trabecular structures of the necrotic bone under stress, i.e., microfracture and subsequent repair process for the damaged bone tissue. The causes of osteonecrosis are not eliminated, the repair is not perfected, and the process of injury-repair continues, leading to structural changes in the femoral head, femoral head collapse, deformation, joint inflammation, and functional impairment. Femoral head necrosis will certainly cause pain, joint movement and weight-bearing walking dysfunction, but people should not be influenced by the horrible meaning of the words “bad and dead”, because necrosis of the femoral head, after all, is limited and involves individual joints, and even if it is serious, it can still be remedied by artificial hip replacement and can still restore walking ability. The signs and symptoms of femoral head necrosis are diverse, the time of appearance of the disease and the degree of attack also vary, but they are all based on the evolution of the pathology. In other words, it is difficult to make a diagnosis of osteonecrosis of the femoral head through the patient’s subjective symptoms and clinical examination. For example, many lesions of the hip and sacroiliac joint can be manifested by a positive “4” test (i.e., bending the knee and making the hip joint flex and abduct and externally rotate, placing it in the shape of a “4” on the contralateral straightened lower limb, pressing the contralateral iliac crest with one hand, and placing the other hand on the medial side of the knee and pressing down at the same time to cause hip pain). The other hand is placed on the medial side of the knee and the other hand is pressed down at the same time, causing hip and hip pain). The most common symptom is pain, which is located in the hip joint, proximal thigh, and may radiate to the knee. The pain can be caused by inflammatory lesions of necrotic tissue-repair or high pressure within the inflammatory lesion and can manifest as constant pain, resting pain. Osteochondral collapse deformation leading to traumatic arthritis, or there is chronic injurious pain in the area of muscle-ligament attachment around the hip joint. Restriction of hip movement, especially rotational movement, or painful and shortening claudication. Treatment: Etiological treatment is the key to terminate the progression of the lesion and make it possible to enter on a benign regression track. For example, for alcohol and hormone intoxication, the first and second leading causes of the disease in China, measures are taken to abstain from alcohol and to end the use of glucocorticoids. Protecting the necrosis that has occurred and at the same time promoting bone regeneration and lesion tissue repair through a biological response to make the repair as complete and effective as possible, restoring the weight-bearing capacity and preventing the femoral head from deforming and collapsing. Therefore, the second key treatment is to reduce weight bearing and walking, to reduce the load on the weight bearing area of the femoral head and to avoid microfractures and collapse of the weakened bone tissue. The patient is advised to walk in small portions, avoid jumping, and rely on support during the progression of necrotic lesions. Encourage patients to do load-reducing exercises, such as cycling and swimming. In the acute progressive stage, bed rest is recommended to avoid weight bearing. It is difficult to intervene with drugs in the necrotic lesions of the femoral head because of the tissue reaction and the attenuated osteogenic regenerative capacity, which cannot be enhanced by drugs. For those who are frequently collapsing or have already collapsed and deformed and have long term painful dysfunction, artificial hip arthroplasty is feasible, which is a mature surgery with positive results and high success rate. Prevention: Avoid alcohol abuse and refrain from using glucocorticoids whenever possible. Strive to achieve anatomical repositioning during internal fixation of femoral neck fracture.