Abstract Background: Femoral head avascular necrosis (FHAN) is one of the most common progressive orthopedic disorders. Previous studies have reported that artificial femoral head replacement (AFHR) can effectively treat patients with FHAN. However, no systematic review has investigated the efficacy of AFHR for FHAN. This study will assess the efficacy of AFHR for patients with FHAN. Methods: We will search MEDLINE, EMBASE, Web of Science, Cochrane Library, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure up to March 1, 2019 without any restrictions. Any randomized controlled trials for assessing the efficacy of AFHR for patients with FHAN. The methodological quality for each eligible study will be assessed by using Cochrane risk of bias tool. Statistical analysis will be conducted by using RevMan 5.3. Results: This study will provide current evidence of AFHR for patients with FHAN from several aspects, including pain intensity, function, and limitation of femoral head, health-related quality of life, and safety. Conclusion: This study will provide latest evidence on assessing the efficacy and safety of AFHR for FHAN. PROSPERO registration number: PROSPERO CRD42019126249.