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This paper reviews the limited empirical research supporting BDSM as a spiritual ritual that enables distinct altered states of consciousness. It expands upon Sagarin, Lee, and Klement’s (2015) preliminary comparison of BDSM to extreme ritual by suggesting that BDSM bears in common with spiritual ritual elements of pain or ordeal, spiritual meaning, and transformative potential. An increasing interest in BDSM in the West is considered in light of the spiritual and ritual roles BDSM fulfills for many practitioners. The relevance of BDSM to transpersonal psychology is discussed and BDSM is considered as an area for further research in transpersonal psychology.