Orthopedic therapeutic biologics (orthobiologics) comprise a variety of tissue grafts and autologous blood products that include platelet rich plasma and mesenchymal stem cell treatment. Surgeons bear responsibility to offer their patients efficacious, safe, and cost-effective treatments. Orthobiologic treatment can be costly and may not be covered by insurance. Patients can become financially vulnerable, especially when pursuing orthobiologic treatment that extends beyond its intended use, scientific support, or regulatory approval. Surgeons should be well versed in the scientific basis, techniques, potential risks, and regulatory status of orthobiologic treatments. Furthermore, surgeons should review the risks, benefits, and anticipated efficacy of orthobiologic therapy with patients in advance. Orthobiologic treatment options represent a rapidly expanding area of interest for both patients and providers, but remain relatively new and understudied. There is ongoing need for investigative research.