Introduction: Osteonecrosis of the femoral head is a progressive and debilitating pathology with several causative factors. Around 1830, Jean Cruveilhier, a French anatomist and pathologist, described femoral head necrosis as a late complication of hip trauma. He suggested that the cause of necrosis was vascular injury. This condition was known as avascular necrosis, ischemic necrosis or aseptic necrosis of the femoral head. Objective: to detail important information related to the epidemiology, pathogenesis, diagnosis, classification and treatment of osteonecrosis of the femoral head. Methodology: a total of 32 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 22 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: osteonecrosis femoral head, avascular necrosis, ischemic necrosis, hip trauma. Results: Osteonecrosis of the femoral head (ONFH) mainly affects young adults between 20 and 40 years of age, with an estimated incidence of 20,000 to 30,000 cases per year in the United States. Its pathogenesis is related to altered blood flow to the bone, which generates an imbalance between bone formation and resorption, resulting in a structurally weak area. Early diagnosis can be complicated, as the disease is often asymptomatic in its early stages, with MRI being the most effective tool for early identification. Treatment varies according to the stage of the disease and ranges from pharmacological options to surgical interventions such as central decompression, bone grafting and arthroplasty, the latter being the only definitive cure. However, hip arthroplasty is not a permanent solution, and young patients may need revision later in life, highlighting the importance of close follow-up. Conclusions: Osteonecrosis of the femoral head affects mainly young adults and is caused by compromised blood flow to the bone, resulting in an imbalance between bone formation and resorption. Although early diagnosis can be complicated, MRI is key to detecting early signs. Although pharmacological treatments have been tried, their efficacy has not been consistently demonstrated, and surgical options, such as hip arthroplasty, are the only definitive cure, although not permanent, which implies the need for close follow-up, especially in young patients who may require future surgeries.