[Objective] To evaluate the clinical efficacy of open reduction and internal fixation (ORIF) with preoperative simulation on 3D printed real model combined with Chinese herb soup for complex acetabular fractures. [Methods] From July 2019 to July 2021, a total of 86 patients received ORIF for complex acetabular fractures. According to doctor- patient communication, 43 patients had ORIF per- formed after preoperative simulation on 3D printed real pelvic model, while the remaining 43 patients received conventional ORIF. All pa- tients in both groups were administrated with Chinese herb soup, the Gushang Fuyuan Tang, after operation. The documents regarding to perioperative period, follow-up and images were compared between the two groups. [Results] All patients in both groups had ORIF finished successfully without serious complications. The 3D group proved significantly superior to the conventional group in terms of operation time, total incision length, intraoperative blood loss, postoperative walking time and hospital stay (P＜0.05) . In addition, the 3D group was also better than that of the conventional group in term of incision healing grade, but which was not statistically significant (P＞0.05) . All of them in both groups were followed up for more than 12 months, and the 3D group resumed full weight-bearing activity significantly earlier than the conventional group (P＜0.05) . The Mere D'Aubigne score, hip extension-flexion range of motion (ROM) and internal-external rotation ROM significantly increased, while VAS score for pain significantly decreased over time in both groups (P＜0.05) , which in the 3D group were significantly superior to the conventional group at all corresponding time points (P＜0.05) . Radiographically, the 3D group proved sig- nificantly superior to the conventional group in term of postoperative fracture reduction quality based on Matta's criteria (P＜0.05) , and frac- ture healing time on images as well (P＜0.05) . The T?nnis classification of hip degeneration deteriorated significantly over time in both groups (P＜0.05) , which in the 3D group were slightly eased compared with those in the conventional group at 6 months and the latest fol- low-up regardless of that the difference was not statistically significant (P＞0.05) . [Conclusion] This 3D printing simulation does consider-ably improve the efficiency and accuracy of ORIF for complex acetabular fractures, while the combined treatment with the Chinese herb soup is beneficial to postoperative rehabilitation.