Femoral head necrosis, also known as aseptic necrosis of the femoral head, or ischemic necrosis of the femoral head, is a type of osteonecrosis. Osteonecrosis is caused by damage to the bone trophoblastic vessels due to a variety of reasons, which further leads to ischemia, degeneration, and necrosis of the bone. Femoral head necrosis is a lesion caused by localized poor blood flow to the femoral head for a variety of reasons, leading to further ischemia, necrosis, trabecular fracture and collapse of the femoral head. Further development can lead to functional disorders of the hip joint, which can seriously affect the quality of life and labor ability of patients, and can lead to lifelong disability if not treated in time. How to determine the staging of osteonecrosis of the femoral head? There are many staging methods for osteonecrosis of the femoral head. Based on long-term clinical observation, we propose a comprehensive staging method based on clinical, X-ray, CT, ECT, MRI, etc. This method can detect suspicious cases at an early stage and help guide the selection of clinical treatment plan and the estimation of disease prognosis. Stage I: clinical manifestations, progressive pain in hip and knee joint, mild restriction of hip joint movement, X-ray manifestations, normal appearance of femoral head, slightly blurred cartilage and trabecular structure, or speckled osteoporosis, CT, mild thickening of trabecular bone in the middle of femoral head, stellate structure, radial or or pseudopod-like branching arrangement to the cartilage part of femoral head, some small cystic changes visible in the subchondral area, ECT with early concentrations. Low arterial blood supply, MRI shows low signal, abnormal changes. Stage II: Hip pain is predominant, abduction and internal rotation are mildly restricted, X-ray shows subchondral cystic changes, bone tissue is interwoven with destruction and laxity, and a semilunar translucent area in the cartilage area is also seen, which is called “crescent sign”. Cystic changes in the subchondral bone marrow cavity of 0.5 cm or more, ECT shows a large “hot zone” (depressed blood) or a large “cold zone” (ischemia) in the resting phase, and there is an intermediate phase of hot and cold intermingling, MRI, a large low signal area. Stage III: Hip and knee pain is aggravated, weight-bearing endurance is decreased, claudication; X-ray shows subchondral microfracture, partial interruption of trabecular continuity, collapse and flattening of the weight-bearing area above the femoral head or fragmented bone fragments under the cartilage; CT shows disturbance of trabecular bone within the femoral head, enlargement of the cystic area, bone fragmentation, deformation of the femoral head, hyperplasia and sclerosis in some areas, osteophytes in the acetabulum; ECT and MRI shows more obvious than stage II. Stage IV: Restriction of hip joint movement, difficulty in walking in severe cases, or loss of labor ability, X-ray shows joint space narrowing, flattened and collapsed deformed femoral head, hyperplasia and deformation of acetabular rim, osteoarthritic changes, CT shows deformation of femoral head contour, joint space narrowing, intermingling of femoral head sclerosis and cystic changes, fragmentation of bone structure, etc. ECT shows local concentration at the junction of the socket head, reduced obliquity of blood pool phase, and a more pronounced osteoarthritis. MRI low signal area was more obvious than stage IIIII.