Spine tumor patients frequently require timely, multi-step, and multi-disciplinary care. Spine Tumor Board (STB) provides a consistent forum wherein diverse specialists can interact, facilitating complex coordinated care for these patients. To present a single large academic center's STB experience specifically reviewing case diversity, recommendations, and quantifying growth over time. All patient cases discussed at STB from May 2006 (STB inception) through May 2021 were evaluated. Collected data submitted by presenting physicians and formal documentation completed during the tumor board is summarized. A total of 4549 cases were reviewed by STB over the study period representing 2618 unique patients. Over the course of the study, a 266% increase in number of cases presented per week was observed (4.1 to 15.0). Cases were presented by surgeons (74%), radiation oncologists (18%), neurologists (2%), and other specialists (6%). The most common pathological diagnoses discussed were spinal metastases (1832; 40%), intradural extramedullary tumors (798; 18%), and primary glial tumors (567; 12%). Treatment recommendations included surgery, radiation therapy, or systemic therapy for 1743 cases (38%), continued routine follow-up/expectant management for 1592 cases (35%), supplementary imaging to better clarify the diagnosis for 549 cases (12%), and variable tailored recommendations for the remainder of cases (18%). Care of spine tumor patients is complex. We believe that the formation of a stand-alone STB is instrumental to accessing multi-disciplinary input, enhancing confidence in management decisions for both patients and providers, assisting with care orchestration, and improving quality of care for patients with spine tumors.