Objective: Fusobacterium nucleatum is an anaerobic gram‐negative bacilli that is one of the oral and other mucosal surface microbiota. It involves a wide range of human diseases and was first found in periodontal diseases, but reports of bone‐related infections caused by F. nucleatum are rare, especially periprosthetic joint infections (PJI). Methods: Here, we present the first case of acute hematogenous PJI of the hip joint caused by F. nucleatum, and debridement, antibiotics, and implant retention (DAIR) was performed. Results: The patient was successfully treated with DAIR, identification of isolates by metagenomics next‐generation sequencing was confirmed by polymerase chain reaction. Conclusions: For stable acute hematogenous PJI after hip replacement, quick and accurate diagnosis, the identification of pathogenic microorganisms, and the use of DAIR combined with sufficient sensitive antibiotics have a certain clinical effect and can achieve the purpose of both preserving the prosthesis and infection control. [ABSTRACT FROM AUTHOR]