Introduction: Subchondral insufficiency fracture (SIF) of femoral head is not very common cause of hip pain. This usually occurs in elderly osteoporotic patients or fatigue fracture in young military recruits.

Case Report: We report a case of hip pain in an osteoporotic male which was diagnosed on MRI after the condition was missed by two physicians initially. Patient responded well to conservative treatment and was asymptomatic at one year follow up.

Conclusion: Purpose of this case is to highlight clinical and radiological features of this entity and to discuss the prognosis and treatment. This case should increase awareness of this rare condition amongst treating physicians. This may facilitate early diagnosis and successful outcome with conservative treatment in selected sub-group of patients having SIF of femoral head.

Keywords: Subchondral Insufficiency Fracture, Femoral Head, Elderly, Osteoporosis

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