A variety of bone grafts and bone graft substitutes is available for treatment of osseous defects although adequate reconstruction of the residual void following fracture, arthroplasty, or tumor/cyst resection remains a therapeutic challenge. This narrative review evaluates the peer-reviewed literature and examines relevant outcomes in patients treated with bone grafts and bone graft substitutes for surgical management of osseous defects. Although autograft, xenograft, and ceramic bone graft substitutes are used for a variety of orthopedic applications, they have distinct limitations in clinical practice. Bone allograft material is a safe and effective adjunct to treatment of osseous defects.