Since Phemister first reported the strut graft of tibial cortical bone for the osteonecrosis of the femoral head in 1948, Bonfiglio and other investigators reported good results of this procedure. Fibular strut graft is one of the joint preserving procedures. It affects femoral head via two mechanisms, decompression and supporting mechanical integrity. The authors studied fibular strut graft in osteonecrosis of the femoral head in 77 patients, 102 hips from March, 1982 to February, 1989 at department of orthopedic surgery, Kyungpook National Univesity Hospital and followed up 70 hips for average 2.5years (minimum 1.5 to maximum 9 years). The authors analysed the results clinically by Harris Hip Score and radiologically according to stage and radiological characteristics of osteonecrosis and tried to define the indication of this procedure. The results obtained were as follows. 1. Men were 71 and women were 6 patients. Of 77 Patients, 46 (60%) were bilateral. 2. The possible etiological factors of osteonecrosis were steroid in 21, alcohol associated in 22, posttraumatic in 8, Caisson's disease in 2 and idiopathic in 27 patients. 3. By Ficat stage, I was 10;II, 37; transition, 23;III, 30;IV, 2 hips. 4. At radiological follow up, 18% was maintained in stage I, 36% in stage II, 28% in transitional and 33% in stage III. 5. At follow up, 60% was aggravated regardless of radiological involvement pattern, density of lesion, crescent sign, and demarcation line. 6. Although average Harris Hip Score was reduced from preoperative 80 points to 72 points at final follow up. Harris Hip Score improved in 34% of cases in spite of radiological progression. 7. Osteonecrosis progressed regardless of the position of the fibular strut graft, therefore fibular graft did not function reliably than we had expected. 8. The function and pain of the hip were better regarding to radiological staging of avascular necrosis.