The author reviews aspects of anatomy and physiology, especially vascularization and pathophysiology, as well as mechanisms of injury that influence the treatment decision for intracapsular fractures of the hip. A number of other factors that may influence surgeons’ choice between treatments are discussed, such as age, displacement, limited life expectancy, chronic disease, and poor bone quality. Avascular necrosis and other complications are also reviewed. Consensus at the time of this article’s publication was that the best treatment for intracapsular hip fractures results in fracture healing, the patient retaining their own femoral head, and the absence of avascular necrosis.