• ➤
    • Femoral neck stress fractures (FNSFs) are an infrequent condition in athletic and military populations.
  • ➤
    • A high index of suspicion with liberal use of magnetic resonance imaging (MRI) is vital for early recognition and treatment initiation.
  • ➤
    • An associated hip effusion on MRI is a risk factor for an evolving stress injury and requires close assessment and consideration for repeat MRI.
  • ➤
    • Stress reactions and stable, incomplete FNSFs (<50% of femoral neck width) can be treated nonsurgically.
  • ➤
    • Surgical intervention is accepted for high-risk, incomplete (≥50% of femoral neck width), and complete FNSFs.
  • ➤
    • Overall, there is a paucity of high-quality literature on the rates of return to activity following FNSF.