Fifty-seven patients with femoral head necrosis (FHN), treated since 1976 at the Orthopaedic Hospital of the Invalid Foundation, Helsinki, were studied. The incidence of alcohol-associated FHN was 29% (N = 15, 13 male) and of idiopathic FHN 11.5% (N = 10, 6 male). Nine patients with alcohol-associated FHN were heavy drinkers, four were alcoholics and two were moderate drinkers at the time of the onset of the symptoms. At follow-up 80% of the alcohol-associated cases showed increased gamma-glutamyltransferase (GGT) activity in the serum. Our findings among alcohol-associated cases support previous reports according to which disturbed liver function is an important factor in the aetiology of FHN. Because of GGT's rather high sensitivity in the detection of heavy drinking in FHN, it is recommended to be used as a diagnostic aid in suspected FHN.