Fractures of the femoral head are rare high-velocity injuries which are usually associated with posterior dislocations of the hip. Outcome of these injuries are dictated by the complications arising from the dual vascular insult due to both dislocation and fracture by itself. Historically, femoral head fractures have been reported to have poor outcomes, as the mainstay of treatment has been mostly conservative management or excision of the fragments. In recent years, the extensive use of CT scans to understand fracture morphology, along with improved familiarity with surgical approaches and better orientation to surgical techniques, has changed the treatment protocols and improved the outcomes. The purpose of this chapter is to summarize the available literature on femoral head injury outcomes with respect to time to intervention, surgical approach selection, management option in various Pipkin subtypes, head indentation injuries, associated acetabular dome impaction injuries, cases of irreducible hip dislocation, and delayed or neglected presentations.