Despite various theoretical explorations regarding spirituality and music therapy, only a small number of empirical studies have been conducted in this area to date. This study aims to explore and provide a systematic overview of music therapists' reported perceptions of spirituality and its relevance (or irrelevance) to their music therapy practice. A pragmatic methodological stance informs this study. Data were collected through an online survey questionnaire which was open to qualified and trainee music therapists across the world. Descriptive statistics and thematic analysis were used to analyse the data. A total of 358 music therapists from 29 countries took part in this study. The survey findings provide an insight into music therapists' perceptions of spirituality including its place in their training, practice and professional life. Also, dilemmas that music therapists face, as well as their suggestions for future action regarding spirituality and music therapy, are explored. To date, this study is one of the largest international music therapy studies on spirituality. Its findings contribute to the growing evidence regarding a subject area that is considered as controversial by many professionals not only in music therapy, but also in other health-related professions.