Non traumatic aseptic necrosis of the head of the femur is well documented with respect to its clinical roentgenographic and pathological aspect, but not with respect to etiology. A num- ber of reports have associated various diseases and conditions with necrosis of the femoral head. Prominent among these are alcoholism, steroid therapy and hemostatic disorder. The in- creased incidence of avascular necrosis of bone associated with long-term corticosteroid thera- py has aroused much interest. The pathogenesis of cortisone-induced avascular necrosis is as yet unproved. But cortisone-induced fatty liver with hyperlipidemia, leading to systemic embolization of fat and avascular necrosis of bone has much experimental support. We present a case of bilateral avascular necrosis of the femur head following several epidu- ral steroid injections in a 30 year old male patient who had low back pain with radiation to both legs for 1 year and who had Cushinoid appearance for several months. One week later, he had a total replacement of both hip operation.