Osteonecrosis of the femoral head is a multifactorial disease that can result in significant clinical morbidity and affects patients of any age, including young and active patients. Late sequelae of femoral head osteonecrosis include femoral head collapse and subsequent degeneration of the hip joint. A high index of suspicion and improved radiographic evaluation allow orthopedic surgeons to identify this disease at an earlier stage. Current management options for hip osteonecrosis have results that vary according to patient population and disease stage. Modifications of older techniques, as well as emerging technologies, have led to the development of management strategies that may be able to alter the course of femoral head osteonecrosis.