Objective To establish a rabbit model of steroid-induced femoral head and explore the effect of Taohong Siwu Decoction (THSWD), a traditional Chinese medicine prescription, on the repair of bone microstructure assessed by high-resolution MRI combinaed with Micro-CT. Methods 25 healthy 24-week old New Zealand rabbits (male:female=1:1) were divided into three groups:5 in the control group, 10 in the model group and 10 in theTHSWD treatment group. We establish the rabbit model with intramuscular injection of endotoxin (LPS) and methylprednisolone (MPS). The treatment group was given 0.3g/kg of THSWD for 8 weeks. The control group and model group were administred with equal volume water for 8 weeks. Then all the femoral heads of rabbits were taken and examined with high-resolution MRI, histopathology and Micro-CT. Results 1) The MRI of the femoral heads of model group revealed a wide range of lower density areas in high resolution MRI,that of the treatment group showed a relatively normal shape of the femoral head with small low density areas. Comparing the treatment group with model group, the values of ROE and ROE/NR were significantly decreased in the THSWD treatment group (P<0.05). 2) The pathological examination showed fracture of bone trabeculae, karyopyknosis, empty lacunae, necrosis of bone marrow cells in the model group (P<0.05). Empty lacunae rate in the model group was much higher in the model group than the normal one (P<0.05). In the THSWD treatment group, bone formation was active and a better trabecular morphology was observed. 3) The micro-CT imaging showed that compared the model group with control group, the values of BV/TV, Conn.D., SMI, Tb.N and Tb.Th in the model group were decreased, while BS/BV and Tb.Sp were increased. The values of BS/BV and Tb.Sp values in the treatment group were significantly lower, while Conn.D., SMI, and Tb.N were increased than that of the model group (P<0.05 for all). Conclusions The results of this study show that Taohong Siwu Decoction can promote the healing of steroid-osteonecrosis of femoral head, the repair of bone microstructure, and improve the biomechanics in the femoral head.