[Objective] To investigate the clinical effect of 3D printing and virtual surgical design based on Solidworks in the treatment of tibial plateau fractures. [Methods ] A retrospective analysis of Twenty-one patients with unilateral complex tibial plateau fractures in our hospital from January 2017 to December 2017 were selected in this study. Using the parity of hospital order, patients were divided into assisted group (11cases，application of 3D printing and virtual surgical design) and normal group (10cases，application of conventional surgery). The operation time, successfully plate place rate, Rasmussen satisfied reduction rate and Postoperative functional score of knee joint were observed. [Results] All the patients were followed-up, the operation time, successfully plate place rate, Rasmussen satisfied reduction rate and knee HSS function score is superior than that in conventional group, and there were statistically significant differences (P＜0.05). [Conclusions] 3D printing and virtual surgical design based on Solidworks can improve surgery effect in the treatment tibial plateau fractures，and it should be paid more attention in clinic.