〔Abstract〕 Objective To investigate the effect of alprostadil on hip joint function in patients undergoing surgical in the treatment of early osteonecrosis of femoral head (ONFH). Methods A total of 256 patients with early ONFH who were admitted to Henan Asia-pacific Orthopaedic Hospital from June 2020 to July 2021 were divided into a control group and an observation group with 128 cases in each group, according to the random number table method. The control group received marrow core decompression β-tricalcium phosphate bioceramic implantation, the observation group received alprostol preoperatively on the basis of the control group. The treatment success rate, pain degree and hip function of the two groups were observed. Results After treatment, the success rate of treatment in the observation group (91.41%) was higher than 82.03% in the control group, and the difference was statistically significant (P < 0.05). The visual analogue scale (VAS) scores in the observation group were lower than those in the control group at 1, 3 and 6 months after surgery, with statistical significances (P < 0.05). After treatment, the scores of pain, daily activities, gait, distance, deformity, application of assistive devices and range of motion in the observation group were higher than those in the control group, with statistical significances (P < 0.05). Conclusion Alprostadil combined with core decompression β–tricalcium phosphate bioceramic implantation in the treatment of early ONFH patients can reduce the pain degree of patients, speed up the recovery of hip joint function and improve the success rate of treatment.