Follow-up of a 22-year-old male presenting with symptoms of hip impingement after post-traumatic ONFH. The patient initially sustained neck of femur fracture, which was treated with closed reduction and internal fixation with cannulated cancellous screws. The fracture failed to unite at 6 months and valgus osteotomy of proximal femur with internal fixation with a double-angle dynamic hip screw was carried out. The fracture united and patient was asymptomatic for 1 year. Subsequently, he presented with hip pain and radiograph showed collapse of femoral head indicating ONFH. He was managed conservatively for 1.5 years. He then developed symptoms of hip impingement, with restriction of hip flexion and rotations. There was no pain on weight bearing or walking. He was managed with arthroscopic osteochondroplasty: panel a: preoperative radiograph showing cam deformity in right femoral head; panels b–d: preoperative CT scan showing extent and location of cam deformity in the femoral head; panel e: post-operative radiograph showing restoration of femoral head sphericity; panels f and g: post-operative CT scan after removal of cam deformity; panels h and i: post-operative follow-up images showing restoration of hip range of motion; panel j: intraoperative image of hip arthroscopy showing identification of the cam deformity; panel k: intraoperative image of hip arthroscopy showing resection of the cam deformity; panel l: intraoperative image of hip arthroscopy after removal of the deformity.