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This study explored the diagnostic value of digital subtraction CT perfusion imaging (SCTP) technology in detecting blood flow (BF), blood volume (BV), and mean transit time (MTT) on early avascular necrosis of the femoral head (ANFH) and its impact on prognosis. Sixty-six patients with unilateral ANFH were taken as the research object. SCTP technique was performed on the femoral head of the affected and healthy side. The results showed that the BF and BV of the femoral head of the affected side were lower than that of the healthy side, and the MTT was longer than that of the healthy side (P<0.05). The AUC of bone BF, BV, and MTT to diagnose ANFH was 0.866, 0.755, and 0.820. The AUC of the three combined diagnosis of ANFH was 0.911, the sensitivity was 95. 45%, the specificity was 83. 33%, and the diagnostic value was higher than that of a single diagnosis (P<0.05). Follow-up for 1 year, 4 cases were lost to follow-up. Among the 62 patients, 41 had a good prognosis and 21 had a poor prognosis. There were statistically significant differences in disease stage, necrotic volume, necrotic location, femoral head BF, BV, and MTT in patients with different prognosis (P<0.05). Femoral head BF and BV were negatively correlated with disease stage and necrotic volume, and MTT was correlated with disease stage, the volume of necrosis was positively correlated (P<0.05). Femoral head BF, BV, MTT were important prognostic factors (P<0.05). Therefore, the SCTP detection of femoral head BF, BV, and MTT has a reliable value in the early diagnosis of ANFH, and it can also provide an important reference for clinical prediction and prognosis assessment. [ABSTRACT FROM AUTHOR]