The synergistic integration of biologics and additive manufacturing (AM) technologies has catalyzed groundbreaking advancements in spinal surgery. These innovations address persistent challenges, such as optimizing fusion outcomes, enhancing tissue regeneration, and achieving precise anatomical compatibility. Biologics have transformed spinal fusion by facilitating bone formation and promoting osteointegration through refinements in traditional materials and cutting-edge biologic developments. Concurrently, AM technologies, including 3D printing and biofabrication, enable the design and production of patient-specific implants and bioengineered scaffolds, significantly enhancing surgical precision and improving treatment outcomes. This review underscores the transformative synergy of biologics and AM, offering a comprehensive exploration of their applications in preclinical research and clinical practice. Together, these synergistic advancements are redefining the field of spinal surgery, driving the evolution of personalized and innovative treatment paradigms.