Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of 3D printed guider on body surface for removing cannulated screw at ankle. [Methods] A total of 5 patients underwent abovesaid procedure to remove cannulated screw in the an- kle. As 3 annular metal spacers were pasted on the body surface of the ankle before surgery to locate the anchor points, and the position of annular spacers was marked on the body surface with a marker pen, CT scan and 3D reconstruction were performed with the positioning spacers, and the scanning data were imported into e3D software to design a body-surface guider with positioning holes. Intraoperatively, the positioning hole of the guider was anastomosed with the marked gasket hole on the body surface, and then the guide wire was inserted into the guider hole, finally, the screw was removed. Intraoperatively, C-arm fluoroscopy was used to evaluate the safety and effectiveness of this surgical method. [Results] Of the 5 patients with 13 screws in total, 4 patients had guide wire placed successfully at one time, while the re- maining 1 patient failed to place the guide wire at the first time with an internal malleolus cannulated screw, and got successful placement at the second time after adjusting the position of the guider. The incision for each screw was about 0.5 cm with time from guider placement to removal of screw of (5.62±2.47) min, the first time success rate of 92.30%, without neurovascular injury and other complications. [Conclusion] This 3D printed guider on body surface has a high success chance to remove cannulated screw in the ankle, additionally, the prepa- ration of guide plate has low material requirements with low cost.