The cases of neglected fracture neck of femur (NOF) present with complications such as nonunion, avascular necrosis of the femoral head and/or resorption of the neck of femur, osteopenia, proximal migration of distal shaft and in all intervened cases, implant failure with or without infection. The treatment of neglected fracture neck of femur is broadly categorized as head sacrificing and head preserving. Following a displaced fracture of femoral neck the blood supply is impaired. Various techniques have been described to restore the blood supply of the femoral head. The viability of the bone in muscle pedicle bone grafting is found to be restored in animal experiment. Meyer’s advocated utilization of vascular principle of muscle pedicle graft to present avascular necrosis of femoral head in cases of femoral neck fracture with posterior comminution. Quadratus femoris, gluteus medius, tensor fascia lata (TFL), sartorius iliopsoas muscle pedicle graft and muscle pedicle periosteal grafts are described. TFL gluteus medius and sartorius graft are applied anteriorly whereas quadratus femoris posteriorly. The muscle pedicle bone graft stimulates early and complete vascularization of femoral head, provides additional source of blood supply and structural support when posterior cortex is comminuted. If not appropriately done breakage of graft displacement of graft may occur.