Abstract: [Objective] To analyze the safety and effectiveness of 3D individualized printing guide in the operation of ankylosing spondylitis (AS). [Methods] 70 as patients were treated in our hospital, 38 patients in 3D group received 3D personalized printing guide fixation, and 32 patients in traditional group accepted traditional internal fixation. The observation indexes include the perioperative condition, follow-up period and imaging evaluation. [Results] The perioperative indexes of 3D group were significantly lower than that of the traditional group (P < 0.05), and the incidence of adverse reactions in 3D group was significantly lower than that of the traditional group (P < 0.05). The spinal pain and functional score of the two groups were significantly improved, and the improvement degree of 3D group was significantly better than that of the traditional group (P < 0.05). The imaging indexes of the two groups were significantly improved, such as the ratio of the height before and after the injury and the Cobb angle of the sagittal kyphosis, and the improvement in 3D group was significantly better than that of the traditional group (P < 0.05). [Conclusion] 3D personalized printing guide has the advantages of safety, efficiency and accuracy in the treatment of as patients, and has satisfactory effect in restoring spine function, relieving pain symptoms and promoting reduction and healing, and can effectively avoid the occurrence of adverse reactions after operation, and has good therapeutic safety and effectiveness.