Realism about quantum theory naturally leads to realism about the quantum state of the universe. It leaves open whether it is a pure state represented by a wave function, or an impure one represented by a density matrix. I characterize and elaborate on Density Matrix Realism, the thesis that the universal quantum state is objective but can be impure. To clarify the thesis, I compare it with Wave Function Realism, explain the conditions under which they are empirically equivalent, consider two (...) generalizations of Density Matrix Realism, and answer some frequently asked questions. I end by highlighting an implication for scientific realism. (shrink)