Free vascularized fibula graft surgery has been shown to be successful in the treatment of osteonecrosis of the femoral head. Refinements in the surgical technique have greatly decreased patient morbidity and overall surgical time. Careful placement of the hip incision is one such refinement. Specific bony landmarks to map out the location of the incision and a simple technique for incision placement are described. An accurately placed 10- to 15-cm incision will allow access to both the proximal femur and the ascending branch of the lateral femoral circumflex artery and veins.