Femoral head avascular necrosis (AVN) is a condition which is characterized by bone cell death due to vascular problems. The diagnosis and treatment of the disease are challenging. Within a very short period of time, asymptomatic disease causes severe joint damage and disability. Although biopsy showing death trabeculae is likely to give the definitive diagnosis, it never results in a successful treatment, as it cannot diagnose the early stage of the disease. At age 40s-50s, these patients usually visit their physician with nonspecific hip or knee pain. In the differential diagnosis of this disease with nonspecific signs, imaging modalities are the most effective methods. The main objective of the femoral head AVN imaging methods are creating a staging system which guides the treatment options. The chance of conservative treatment is present in early stages, however challenging and risky surgical methods including total hip arthroplasty is likely to be performed in advanced disease.