Abstract Objective:To explore the curative effect of SuperPATH approach and posterolateral small incision total hip arthroplasty for the treatment of femoral head necrosis; Method: 65 patients with ONFH who met the inclusion criteria were selected from June 2017 to June 2019 in our hospital, all underwent THA After surgery, the conventional group received small-incision posterior lateral surgery, and the research group received SuperPATH surgery. The general perioperative indicators, postoperative full weight-bearing activity time, postoperative follow-up 6 months, and last follow-up VAS score, Harris were observed in the two groups. Score, observe the difference of acetabular abduction angle, anteversion angle, and bilateral limb length before operation, after operation and at the last follow-up. Results: In the SuperPath group, the operation time was long, the first time to get out of bed and the hospital stay after the operation were shortened, the incision was short, the difference was statistically significant (P<0.05), and the intraoperative blood loss was not statistically significant (P>0.05); Weight-bearing time SuperPath The group was significantly better than the PLA group (P<0.05). There was no significant difference in the preoperative VAS score and Harris score between the two groups (P>0.05). The VAS scores of the two groups gradually decreased after the operation, and the Harris score gradually increased. The difference between VAS score and Harris score in June was statistically significant (P<0.05), but there was no significant difference between VAS score and Harris score at the last follow-up (P>0.05). There was no significant difference in acetabular abduction angle and anteversion angle between the two groups before and at the last follow-up after operation (P>0.05). The limb length difference between the two groups before and after operation was not statistically significant (P>0.05), but the difference in limb length after surgery was significantly shorter than that before operation, and the difference was statistically significant (P<0.05). Conclusion: The SuperPATH approach has little tissue damage during THA operation, and the patient recovers quickly in the early stage, relieves the pain symptoms of the patient, and promotes the recovery of hip joint function. It can be used as a reliable surgical method for the treatment of ONFH.