Steroid-induced osteonecrosis of the femoral head (SONFH) is an ischemic necrotic bone disease caused by long-term use of glucocorticoids, characterized by a high incidence rate and severe disability risk. Its pathogenesis is complex, and early diagnosis remains challenging. Circular RNA (circRNA), a novel class of non-coding RNA, has been shown to play a significant role in the occurrence, progression, and clinical management of SONFH. With ongoing research, circRNAs have been found to regulate gene expression through the competing endogenous RNA (ceRNA) mechanism, affecting the differentiation of osteoblasts and osteoclasts, thereby modulating bone metabolism. Abnormal expression of specific circRNAs has been identified in the blood or bone tissue of SONFH patients, providing a basis for their potential use as diagnostic biomarkers and therapeutic targets. This review summarized the recent research progress on circRNAs in SONFH, focusing on their regulatory mechanisms, biological functions, and potential as diagnostic markers and therapeutic targets, offering new insights into the early diagnosis and treatment of SONFH.