The options for treatment of the young patient with late-stage avascular necrosis of the femoral head are limited. The authors performed a conservative type of femoral hemiarthroplasty on a select group of patients. They chose for the series only patients with Ficat stage III and IV avascular necrosis, particularly those who had an intact acetabulum and femoral-head involvement only. Of 19 procedures followed for an average of 36 months, there were 84% good and excellent results. The authors feel that this operative procedure may have a role in the treatment of this specific group of young patients.