Background: The avascular necrosis (AVN) or osteonecrosis of the femur head (ONFH), an illness with several etiological factors, impacts young populace and otherwise handled prompt, causes the collapse of femur head eventually requiring hip arthroplasty. Objective: the present article aims to provide an overview of epidemiology, pathophysiology of osteonecrosis along with diagnosis methods and non-surgical in early stages and surgical treatment methods. Methodology:  Comprehensive search of the literature was conducted in the following databases; PubMed, and SciVerse Scopus for studies published before November 2017. The PubMed database was searched using an algorithm comprising relevant MeSH terms including “Osteoporosis", “femoral head osteonecrosis" AND “management" “diagnosis".
Conclusion: Osteonecrosis is a destructive pathology that eventually results in bone death through loss of blood to the bone, it involves almost every bone including the femoral head while early start of osteoarthritis could ultimately demand hip arthroplasty when non-operative procedures and joint-sparing treatments fail. Nevertheless, recent technological advances in surgical treatment methods have improved outcomes and should help patients recover from this functionally debilitating joint disease.