Steroid-induced avascular necrosis of the femoral head (SANFH) is a common and intractable disease with high disability rate and poor prognosis, which is a serious threat to human health. The pathogenesis of SANFH is very complex, but more and more studies have shown that high doses of glucocorticoids would cause abnormal mitochondrial function of bone tissue cells, oxidative stress, mitochondrial autophagy, and altered mitochondrial dynamics, resulting in cell damage or death. These would then lead to imbalance of bone metabolism and abnormal blood flow in the femoral head, accelerating the occurrence and development of SANFH. With advantages of high safety and low side effects, Chinese medicinals have a good effect in the treatment of SANFH. Compound formulas, single Chinese medicinal and active ingredients of Chinese medicinals can directly or indirectly regulate the expression of key molecules in the corresponding signaling pathways, improve mitochondrial function at multiple targets, and significantly prevent the occurrence and development of SANFH, which have attracted wide attention from scholars. This paper reviews the relationship between SANFH and mitochondrial function, and the mechanism of Chinese medicinals preventing and treating SANFH by modulating mitochondrial function, in order to provide certain ideas and methods for the treatment of SANFH by applying Chinese medicinals to modulate mitochondrial function.