Objective To investigate the clinical significance of prediction of collapse with early MRI signs and necrosis volume measurement for Osteonecrosis of the Femoral Head (ONFH). Methods From July 2012 to July 2014, 65 patients (78 hips) with early ONFH (ARCO Ⅰ、Ⅱ) confirmed in our hospital were included in this study. At the time of diagnosis, X-ray film was taken to determine the collapse of femoral head, and MRI scan was performed to collect early data, including the joint effusion, bone marrow edema, necrotic morphology and the volume of femoral head necrosis. After the first examination, the patients were demanded to receive an X-ray film every 6 months to observe whether the collapse of the femoral head or not. Then, all hips were divided into two groups, collapse group and non-collapse group. The early MRI signs of the two groups were compared, and the correlation between the indexes and the collapse of the femoral head was analysed. Results The total necrosis volume percentage of the femoral head of the collapse group was significantly higher than that of the non-collapse group, and the necrosis volume percentage of each quadrant were greatly higher than those of the non-collapse group except the PIM quadrant. The degree of ioint effusion of the collapse group was more than that of the non-collapse group. The cases of bone marrow edema of the collapse group was more than those of the non-collapse group. The proportion of peripheral femoral head necrosis of the collapse group was higher than that of the noncollapse group. The differences were statistically significant (P<0.01). Conclusion Early MRI signs and necrosis volume measurement have important clinical value in predicting the collapse of the femoral head.