Abstract：Objective：To observe the effect of nursing based on syndrome differentiation combined with routine nursing on patients with femoral head necrosis after the hip replacement. Methods：A total of 113 cases of patients with femoral head necrosis who underwent the hip replacement were divided into the control group and the observation group according to the random number table method， 56 and 57 cases in each group respectively. The control group was given routine nursing intervention of western medicine， and the observation group was additionally given nursing based on syndrome differentiation of Chinese medicine based on the nursing of the control group. The changes in the hip joint function， life quality，incidence of postoperative complications，and nursing satisfaction were compared between the two groups before and after nursing. Results：After nursing，the hip joint function in the two groups was improved when compared with that before nursing，and the scores of pain，joint function，range of motion，and joint deformity in the observation group after nursing were better than those in the control group(P＜0.05). After nursing， the scores of emotional function， mental health，psychological state，physiological function，activity ability，social function，physical pain，and overall health in the observation group were superior to those in the control group(P＜0.05). The incidence of postoperative complications and nursing satisfaction in the observation group were better than those in the control group(P＜0.05). Conclusion：For patients with femoral head necrosis who underwent the hip replacement，nursing based on syndrome differentiation combined with routine nursing can effectively reduce the incidence of postoperative complications，and improve their hip joint function，life quality，and nursing satisfaction.