BACKGROUND: Shengyu Decoction can be used to treat osteonecrosis of the femoral head (ONFH), but its mechanism is unknown. OBJECTIVE: To explore the molecular mechanism of Shengyu Decoction in treating ONFH based on network pharmacology and molecular docking technology. METHODS: The active components and corresponding targets of Shengyu Decoction was screened by TCMSP database. The related targets of ONFH were obtained by the query results of GEO chip, OMIM and Gene Cards databases. The potential targets of Shengyu Decoction in the treatment of ONFH were obtained by mapping intersection by Venny platform. The network of “single drug-active target-potential target” and protein-protein interaction network of Shengyu Decoction in the treatment of ONFH were constructed by Cytoscape software. The action targets of Shengyu Decoction were analyzed by David database through the gene ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Autodock vina software was used to carry out molecular docking between key effective components and important targets, followed by the assessment of their binding activity. RESULTS AND CONCLUSION: A total of 66 active ingredients and 196 targets of Shengyu Decoction and 6 045 related targets of ONFH were screened out, and 73 intersected targets of Shengyu Decoction in the treatment of ONFH were obtained. The “single drug-active ingredient-target” network indicated that the main active ingredients were kaempferol, quercetin, β-sitosterol, stigmasterol, isorhamnetin, etc. Protein-protein interaction analysis showed that the main core targets were interleukin-6, vascular endothelial growth factor A, matrix metalloproteinase-9, etc. The GO functional enrichment analysis yielded 804 entries (P < 0.01), mainly involving oxidative stress response, angiogenesis regulation, cell cycle regulation, immune response, inflammatory factors, etc. The KEGG pathway enrichment analysis obtained 120 pathways, mainly involving hypoxia-inducible factor-1α signaling pathway, interleukin-17 signaling pathway, tumor necrosis factor signaling pathway, nuclear factor-κB signaling pathway, Toll-like receptor signaling pathway and other pathways related to inflammatory response, angiogenesis and immune regulation. Molecular docking results showed that the binding energies of the five core target proteins and the five main active components were far less than the reference values, indicating that the main active components are stably bound to the core target receptor proteins. To conclude, Shengyu Decoction can participate in the regulation of immune-inflammatory responses, bone metabolism, angiogenesis, and oxidative stress through the active components such as kaempferol, quercetin, β-sitosterol, stigmasterol, and isorhamnetin, thereby playing a role in the treatment of ONFH. [ABSTRACT FROM AUTHOR]