Background: Bone grafts are widely used in the treatment of periodontal osseous defects. However, many are unfamiliar with their preparation, exact mechanism of action and processing as well as their use as safe and effective graft materials in periodontal therapy. Also, the clinical benefits of this therapeutic practice require further clarification through a proper review. Aim: The purpose of this review is to access the efficacy of bone replacement grafts in proving demonstrable clinical improvements in periodontal osseous defects. Methods: Data Sources: A literature search was conducted on several medical databases. For study inclusion, all studies that used bone graft in the treatment of periodontal osseous defects were included. Around 80 relevant articles were selected for this review. Results: A large body of evidence clearly indicates that grafts consistently lead to better bone fill than non grafted controls. As more is learned about the biologic process of periodontal regeneration, new graft materials are expected to make the task of periodontal regeneration even more predictable. Conclusion: Bone replacement grafts (BRG) are widely used in the treatment of periodontal osseous defects. Our review of literature strongly suggests better bone fill, gain in clinical attachment level and reduced probing depths with the use of various grafts as compared to non grafted sites. However, the clinical benefits of this therapeutic practice require further clarification through a systematic review of randomized controlled studies. Keywords: bone grafts, periodontal regeneration, prognosis