For the past 30 years, nonvascularized bone grafts have been used in the treatment of osteonecrosis of the femoral head. Originally, various tibial, fibular, or iliac crest grafts were introduced through a core track into the femoral head. These produced less than optimal long-term results. More recently, various grafts have been used through windows made in the femoral neck or head to more directly replace the dead bone and support the collapsing segment. Results of these recent techniques are promising and may be further improved in the future by pharmacologic agents that enhance bone healing.