ABSTRACT Avascular necrosis (AVN) often affects bones with a single terminal blood supply, such as the femoral head, carpals, talus, and humerus. Femoral head is one of the most common sites for AVN and its cause can be primary or secondary to other pathology. It occurs because of an interruption in the blood supply to the femoral head that causes bone death. It was first described in 1738 by Munro. Treatment depends on the severity of the disease, as well as the patient’s age and general health. Treatment outcomes correlate directly with the stage of the disease and no medical treatment has proven effective in preventing or arresting the disease process. Hence, in this case series study, four patients presenting with similar complaints of pain and stiffness in the hip joint (right/left/bilateral) and difficulty in walking and climbing stairs were studied. All of the patients were adults above 30 years and included two male and two female patients. Examinations of the patients were done both according to modern and Ayurvedic parameters. The subjective and objective criteria assessed before and after treatment included the number of joints involved, gait, muscle wasting, straight leg raise test, pain, tenderness, stiffness, and decreased range of motion. Astavidha and Dashavidha Pariksha were done for all the patients. Detailed history was taken to evaluate the specific Nidanas and based on the Lakshana and the Nidanas, the involved Dosha, Dushya, Agni, and Srotas were evaluated and the Samprapti was designed accordingly for each patient separately. Diagnosis was confirmed on X-rays or magnetic resonance imaging of the hip joints. These cases were studied taking the etiologies, the clinically manifested signs and symptoms into consideration and correlated with the disease Asthi-Majjagata Vata mentioned in the classics. Ayurvedic management principles were adopted accordingly such as Nidan Parivarjanam, Deepan-Pachana, Snehapana, Abhyanga, Nadisveda, and Basti along with internal medicines and mobilization exercises. The symptoms such as pain and stiffness improved with just 7 days of treatment and by the completion of the Tiktakshira Basti, the patient had significant improvement in the signs and symptoms such as pain, stiffness, tenderness, and restricted mobility. On discharge, all the patients had overall health improvement. Follow-up of the patients was advised after 15 days from discharge.