Spinal fusion is a gold-standard treatment for many disorders of the spine with autogenous bone graft as the gold-standard source for augmenting fusion. However, the morbidity and limitations of autogenous bone grafting has motivated the search for bone graft alternatives. One such alternative is demineralized bone matrix (DBM). The purpose of this paper is to describe and characterize the properties of DBM in addition to reviewing the results of its use in animal and human studies of spinal fusion. A thorough and critical review of the English-language literature was conducted. DBM is both osteoconductive and osteoinductive. Studies have produced variable results with respect to spinal fusion rates. Various studies have demonstrated inferior, equal, or enhanced fusion rates. Some of the differences in these studies include the animal models used, the manner in which DBM was prepared, and the carrier with which DBM was combined. These differences may account for the dissimilar results. DBM is able to function as a graft extender in the human species.