Osteonecrosis of the femoral head (ONFH) is a complex and challenging condition in orthopedic practice. Its pathogenesis is centered on the closely linked pathological processes of femoral head blood supply, bone necrosis progression, and bone repair. Interventional vascular therapy has emerged as a minimally invasive and hip-preserving treatment modality aimed at improving intraosseous blood circulation and the microenvironment within the necrotic region. This approach is gaining increasing recognition among orthopedic surgeons. Despite its extensive clinical application, there is currently a lack of expert consensus or guidelines to standardize the implementation of interventional vascular therapy for ONFH. To address this gap, this research group employed methodologies including bibliometric analysis, consensus conferences, and the Nominal Group Technique to comprehensively review and analyze the current state of research on interventional vascular therapy for osteonecrosis of the femoral head. By integrating expert recommendations, we have thus developed the China expert consensus on interventional vascular therapy of osteonecrosis of the femoral head. This consensus formalizes key aspects of the procedure, including indications, contraindications, pharmacological selection, interventional techniques, and complication management, with the ultimate goals of enhancing clinical efficacy and preventing and reducing adverse effects.