Objective To analyze the value of single photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) in the diagnosis of early avascular necrosis of femoral head (ANFH). Methods A total of eighty-eight patients with early ANFH who were admitted to the hospital during the period from May 2014 to June 2017 were enrolled in the study. The results of SPECT and MRI diagnosis were compared with the clinical diagnosis. The clinical value of SPECT and MRI in diagnosis of early ANFH was compared. Results Among 88 patients, 62 cases were diagnosed as early ANFH, 12 cases were rheumatoid arthritis, 7 cases were temporary osteoporosis, 1 case was chondroblastoma in femoral head and 6 cases were pigmented villonodular nodular periostitis. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and kappa value of PECT in diagnosis of early ANFH (98.38%, 88.46%, 95.45%, 95.31%, 95.83% and 0.888) were higher than those of MRI (93.51%, 50.00%, 80.68%, 84.69%, 76.47% and 0.484), with statistically significant differences in specificity, accuracy and negative predictive value (P<0.05). Conclusion Both of SPECT and MRI had high specificity, accuracy and negative predictive value in the diagnosis of early ANFH, and it is worthy of clinical application.