Abstract: Objective To study the early imaging signs of aseptic osteonecrosis of the femoral head in adults. Methods The X-ray plain films and CT scans of 80 cases with this condition were analyzed. Results There were 40 hip joints with the femoral head normal in shape, including 49 femoral heads with only high-density sclerosis and 26 ones with high-density and low-density areas. Air-filled cysts appeared in 12 femoral heads. In the other 40 hip joints, the femoral heads were depressed and manifested purely highdensity sclerosis in 8 and mixed-density areas in 63. Air-filled cysts appeared in 22 femoral heads. Conclusions Purely high-density sclerosis and air density in the femoral heads are the early signs of aseptic ostenecrosis of the femoral head. The special CT signs are of great diagnostic value and can provide more information for the surgeons.