Abstract:[Objective] To evaluate the clinical outcomes of 3D printing-assisted percutaneous cannulated screw fixation of acute car- pal scaphoid fracture. [Methods] From January 2019 to December 2020, a total of 60 patients with carpal scaphoid fracture were enrolled in this study, and were divided into two groups by random number table method, with 30 patients in each group. Before surgery, mimics soft- ware and 3D printer were used to make 1:1 real fracture model and percutaneous guider, and then palmar percutaneous screw placement was conducted under the guider in the 3D group. By comparison, conventional percutaneous screw placement was performed in the free- hand group. The clinical and imaging data of the two groups were compared. [Results] Surgical procedures were successfully completed in both groups. The 3D group proved significantly superior to the freehand group in terms of operation time, fluoroscopic frequency and VAS score one day after surgery (P＜0.05) . The patients in both groups were followed up for 8~15 months, with an average of (10.14±2.35) months. The 3D group had significantly lower incidence of postoperative complications than the freehand group (P＜0.05) , despite no signifi- cant difference in VAS score and clinical outcome grades between the two groups at the latest follow-up (P＞0.05) . In terms of imaging, the 3D group proved significantly superior to the freehand group in accuracy of screw insertion point and screw length (P＜0.05) . [Conclusion] This 3D printing- assisted percutaneous cannulated screw internal fixation for acute carpal scaphoid fracture does shorten the operation time and reduce intraoperative fluoroscopic frequency.