In a study, researchers compared trends in adult spinal deformity (ASD) surgery utilization rates and perioperative surgical metrics across Black and White patients in the United States who were receiving operatonal treatment for ASD. Adult patients who had ASD surgery between 2004 and 2014 were found in a nationwide inpatient sample (NIS). Over time, the use rates, significant complications rates, and length of stay (LOS) for Black and White patients were compared. Annual census data was used to calculate use rates per 1,000,000 inhabitants in subpopulations stratified by race. All reported complications and prolonged hospital stay rates were adjusted for the Elixhauser Comorbidity Index, zip code income quartile, and insurance payer status. Between 2004 and 2014, Black patients’ ASD utilization climbed from 24.0 to 50.9 per 1,000,000 people, while White patients’ ASD utilization increased from 29.9 to 73.1 per 1,000,000 people, demonstrating a substantial increase in racial disparities in ASD usage (P-trend<0.001). Across the time period analyzed, there were no substantial differences in complication rates or rates of prolonged hospital stay between Black and White patients (P>0.05 for both). Although postoperative complications and length of hospital stay do not differ significantly between Black and White’s patients receiving ASD surgery, there had been a rising difference in ASD surgery use between White and Black patients in the United States from 2004 to 2014. The search for solutions to eliminate racial disparities in the surgical selection and perioperative management in spine deformity surgery might continue.