The aim of this paper is to study some models of quasi-birth-and-death (QBD) processes arising from the theory of bivariate orthogonal polynomials. First we will see how to perform the spectral analysis in the general setting as well as to obtain results about recurrence and the invariant measure of these processes in terms of the spectral measure supported on some domain $Ω\subset\mathbb{R}^d$. Afterwards, we will apply our results to several examples of bivariate orthogonal polynomials, namely product orthogonal polynomials, orthogonal polynomials on a parabolic domain and orthogonal polynomials on the triangle. We will focus on linear combinations of the Jacobi matrices generated by these polynomials and produce families of either continuous or discrete-time QBD processes. Finally, we show some urn models associated with these QBD processes.