To study the application value of standard 3D printed guide plate in atlantoaxial fracture and dislocation pedicle screw fixation operation. Methods The data of Eighty patients with atlantoaxial fractures and dislocations in our hospital from December 2016 to November 2018 were reviewed. All patients were treated with pedicle screw internal fixation, of which 42 patients used a benchmark 3D printed guide plate to assist in the placement of nails In the observation group, 38 cases were treated with conventional "C" arm fluoroscopy as the control group. The operation situation, the visual simulation (VAS) score at 3 months before, 3 months after operation and the last follow-up, and the Japan orthopaedic association (JOA) score were analyzed. The pedicle screw position and the ideal nail track with the nail track during surgery. Inclination, tail and screw placement accuracy were compared between the two groups. Results The observation group's operation time, intraoperative bleeding, and number of fluoroscopy were significantly lower than those of the control group, and the differences were statistically significant (P<0.05); the VAS scores at 3 months and the last follow-up were significantly lower in the two groups than before the operation, and the JOA score was significant The difference was statistically significant (P<0.05), but there was no statistically significant difference between the groups (P>0.05). There was no significant difference in the left and right inclination angles and left and right tail inclination angles between the ideal and atlantic and pivotal pedicle screws of the observation group and the nail channel during the operation (P>0.05). The differences in the control group were statistically significant (P<0.05); the accuracy of screw placement in the observation group was better than that in the control group, and the difference was statistically significant (P<0.05). Conclusion The benchmark 3D printed guide can significantly improve the accuracy of atlantoaxial fracture and dislocation pedicle screw fixation nail placement, and improve the safety of nail placement