0bjective：To introduce the surgical technique and preliminary clinical outcomes of active registration and 3D printed superficial template for removing cannulated screw on ankle. Methods：patients needed to remove cannulated screw on ankle were chosen，three metal gaskets used for function of locate anchor were place on the surface of their ankle pre-operation，and then signed theirs exactly location by marking pen before examination of CT. e3D software designs 3D printed superficial template with location hole and guide hole based on data of CT scanning. Guide wires were inserted to cannulated screw through guide hole of 3D printed superficial template by means of coincide location hole with marked hole on ankle surface，and then removed screw. As well as evaluate the effectiveness and safety of application, combined with intraoperative C-arm fluoroscopy. Results:4 of 5 patients were found to insert the guide wire accurately only one time. Only one medial malleolus hollow screw on one patient as to all 13 screws was failed to insert the guide wire for the first time, and the guide wire was successfully inserted after re-adjusting the position of the template. they were minimally invasive operation with only 0.5cm incision for every hollow screw, The time from place 3D printed superficial template to screw removal was only need (5.62±2.47) mins, and the success rate of one time insertion guide wire to hole on cannulated screw was 92.30%, without neurovascular injury and other operation complications. Conclusions: Surgical technique of active registration location and 3D printed superficial template for removing cannulated screw on ankle were different from template placed on bone surface. It can not only realize precision but also minimally invasive without cut out skin for placement template on inner of body, while unnecessarily need special printed material with low cost，so it has certain value in clinical application on the operation of removing cannulated screw on ankle.