SummaryNonunion is a frequent complication following femoral neck fracture. While healing of the femoral neck fracture and preservation of a viable femoral head appear to offer the best outcome for managing femoral neck nonunions, the choice of treatment depends on patient age, congruity of the femoral head, quality of existing bone, and expertise of the surgeon. For patients less than 60 years of age with a congruent femoral head, procedures to stimulate union are preferable. Nonunion, with or without displacement, and associated shortening should be treated with a valgus intertrochanteric wedge osteotomy in younger patients. In the absence of displacement or shortening, refixation is indicated. Avascular necrosis without collapse is not in itself a contraindication to osteotomy, as acceptable results have been reported. Patients 60 years of age or older with a femoral neck nonunion are best managed by total hip arthroplasty. Available literature supports a cemented hip done through an anterior approach to decrease potential complications.