Many attempts have been made to establish a radiological classification of proximal femoral focal deficiencies (PFFDs), which allow early decisions to be made concerning the prognosis and management of this condition. We reviewed the radiographs of 27 patients with 35 involved femurs. Each femur was staged using five different classifications at various ages. In many cases, the stages varied during growth. The radiological parameters described by Fixsen and Lloyd-Roberts were eventually found to be the most reliable factors for predicting future outcome of the femur.