Abstract: [Objective] To explore and analyze the clinical application value of 3D printing combined with virtual surgical design in the treatment of complex tibial plateau fracture. [Methods] Selected a total of 60 patients with tibial plateau fractures from June 2018 to June 2019. Using random number table method, they were randomly divided into 3D group and conventional group, with 30 people in each group. The normal group received conventional surgery. In the 3D group, a virtual surgical design was used to simulate fracture reduction and the placement of internal fixation materials, and then, the 1:1 fracture model was printed by 3D technology to get familiar with the surgical operation. [Results] Comparison of perioperative data showed that the 3D group was superior to the conventional group in terms of operation time, incision length, intraoperative blood loss, intraoperative fluoroscopy times, plate placement times, incidence of postoperative tension blisters and length of hospital stay, with statistical significance (P＜0.05)；The postoperative follow-up results for 1 year showed that the 3D group was superior to the conventional group in terms of walking time, full weight-bearing activity time, postoperative VAS score, HSS score, and knee extension-flexion ROM, with statistical significance (P＜0.05)；Imaging data indicated that the 3D group was superior to the conventional group in terms of fracture reduction quality, proximal medial Angle of tibia and posterior Angle of tibial plateau, with statistical significance (P＜0.05). [Conclusion] In the application of 3D printing combined with virtual surgical design in the operation of complex tibial plateau fracture surgery, the preoperative surgical planning and simulation operation can effectively shorten the operation time, reduce the amount of surgical bleeding, improve the quality of fracture reduction, and promote the recovery of patients' knee function, which is worthy of further clinical promotion.