STUDY DESIGN: Cross-sectional study. OBJECTIVES: To assess global practices and preferences in the use of osteobiologics for anterior cervical discectomy and fusion (ACDF) and identify factors influencing the choice of specific osteobiologics. METHODS: An online survey developed by AO Spine was distributed to spine surgeons worldwide. The survey captured demographic characteristics, osteobiologic use and related information (i.e., previous training, practice patterns, etc.), and factors influencing osteobiologic choice in ACDF. Descriptive statistics, Chi-square tests, and multiple logistic regression were used to analyze responses, focusing on the associations between osteobiologic use and variables such as training, cost awareness, and regional practices. RESULTS: Responses from 458 surgeons revealed regional variability in osteobiologic preferences. Autologous iliac crest bone graft (AICBG) was predominant in Asia Pacific and Middle East, while allograft and demineralized bone matrix were favored in North America and Latin America ( CONCLUSIONS: Significant variation exists in osteobiologic use in ACDF across global regions, influenced by surgeon training, cost awareness, and institutional resources. Enhanced training and guidelines could improve consistency in osteobiologic application.