Objective To evaluate the efficacy and safety of Bushen Huoxue traditional Chinese medicine n the treatment of early and middle femoral head necrosis. Methods A total of 7 commonly used English databases （PubMed, Cochrane Library, Clinical trials.gov） and Chinese databases（CNKI, Wanfang, VIP, CBM） were searched, and the literature was selected according to the proposed inclusion criteria and exclusion criteria. The Cochrane Handbook for Systematic Reviews of Interventions was evaluated for quality and meta-analysis was performed using Rev Man 5.3 software. Results A total of 1542 articles were retrieved, and 11 articles were included in the screening, including 9 Chinese articles and 2 foreign literatures. Studies have shown that Chinese medicine Bushen Huoxue method can improve the clinical efficiency, Harris score and hemorheology of patients with early and middle femoral head necrosis. Conclusion According to the existing literature, traditional Chinese medicine Bushen Huoxue therapy has certain curative effect on early and middle femoral head necrosis, and its effect is better than western medicine, but the included literature has a certain degree of selection bias, which affects the strength of the argument. The reliability of the conclusions needs further confirmation with a large sample of multicenter trials.