Osteonecrosis of the femoral head seems to be due to circulatory disturbance of the femoral head, usually idiopathic in origin, but also associated with chronic alcoholism, gout, prolonged treatment with corticosteroids, sickle cell disease, Caisson's disease and surface and degenerative changes in the hip joint. Aims of this procedure are to decompress the femoral head hence allowing better circulation, to revitalize the dead head by insertion of vascularized pedicle bone and to give a mechanical support preventing further collapse of the femoral head. Authors reviewed 19 cases of the vessel pedicled iliac bone graft performed for the idiopathic osteonecrosis of femoral head from January, 1984 to April, 1988 with follow-up periods from 23 months to 66 months, average 37.5 months. The purpose of this follow-up note is to report the long term follow-up result and to show the critical points of this technique.