Avascular necrosis (AVN) is a disease without a definitive consensus on the underlying pathology, and many factors play a role in its development. The common endpoint of the different mechanisms proposed in the development of the disease is ultimately the deterioration of blood flow in the femoral head. Recommended pharmacological and biological (biophysical) treatments are aimed at preventing the underlying risk factors and proposed mechanisms. The main pharmacological treatments are acetylsalicylic acid, bisphosphonates, anticoagulants, statins and vasodilators. Among the biological treatments, hyperbaric oxygen, extracorporeal shock wave therapy and electrical stimulation therapy can be counted. The level of evidence showing the efficacy of these treatments in preventing the progression of the disease is insufficient. They are considered to be not suitable for use in the early stages where joint preservation is a priority, except for small medial lesions.