This review article focuses on the development of bioactive 3D composite scaffolds for bone tissue engineering (BTE). It highlights the limitations of current bone grafts and the need for novel alternatives. The ideal properties of a 3D scaffold are discussed, including biocompatibility, biodegradability, mechanical performance, and bioactivity. Various manufacturing methods, such as 3D printing, are reviewed, emphasizing their advantages and challenges. The article also examines the use of different materials, including polymers, hydrogels, metals, ceramics, and bio-glasses, in BTE. Each material's unique properties and their potential in creating composite scaffolds are explored. The review concludes by discussing the clinical translation of these 3D bioactive composite scaffolds and their potential to improve bone regeneration.This review article focuses on the development of bioactive 3D composite scaffolds for bone tissue engineering (BTE). It highlights the limitations of current bone grafts and the need for novel alternatives. The ideal properties of a 3D scaffold are discussed, including biocompatibility, biodegradability, mechanical performance, and bioactivity. Various manufacturing methods, such as 3D printing, are reviewed, emphasizing their advantages and challenges. The article also examines the use of different materials, including polymers, hydrogels, metals, ceramics, and bio-glasses, in BTE. Each material's unique properties and their potential in creating composite scaffolds are explored. The review concludes by discussing the clinical translation of these 3D bioactive composite scaffolds and their potential to improve bone regeneration.