This chapter discusses the avascular necrosis of femoral head and its management. Avascular necrosis (AVN) of the femoral head has become a subject of interest amongst the orthopedic surgeons only during the last four to five decades. Traumatic, idiopathic, corticosteroid-induced, alcohol abuse, following infection, hemoglobinopathy, post irradiation, Caisson’s disease, Gaucher’s disease and associated with gout are several etiological factors of osteonecrosis. The femoral head is one of the common sites for osteonecrosis due to its poor collateral circulation and characteristic architecture consisting of relatively avascular fatty marrow and sinusoidal network, both of which are susceptible to tamponade effect from any cause. Diagnosis of AVN of the femoral head is done by pain around hip; gradual limitation of motions, radiographic criteria, radionuclide scintigraphy which are valuable only in early stages of AVN. The natural history of AVN of the femoral head resulting from different causes needs consideration in the planning of its treatment protocol. Conservative treatment, operative treatment and femoral head-preserving operations are the treatment options for AVN.