Avascular necrosis (AVN) is characterized by cell death of trabecular bone leading to bone collapse and subsequent joint destruction. Recently, application of bone marrow derived MSCs has been proposed as adjunctive treatment to core decompression for osteonecrosis of femoral head. There have been several studies, which report that BMAC application results in the improvement of outcomes; nevertheless, it is dependent on the stage of osteonecrosis. Superior outcomes are reported, similar to bone preserving procedures in the pre collapse stages. Additionally, the technique has not been associated with any significant complications. The current results are encouraging, however, more studies are required.