This study presents a novel 3D-printed bilayer small-diameter vascular graft (BSDVG) designed to facilitate rapid smooth muscle layer (SML) regeneration and improve vascular function. The inner layer of the BSDVG has larger pore sizes and high porosity to enhance cell infiltration and circumferential alignment, mimicking the natural SML. The outer layer, designed to induce fibroblast recruitment, has smaller pore sizes and denser fiber intersections to provide sufficient mechanical strength. In vivo experiments in rats showed that the BSDVG exhibited better pulsatility and compliance compared to electrospun grafts, with a compliance of 8.9% and a pulsatility approaching that of natural arteries (11.36%). The BSDVG also demonstrated a three-layer structure similar to natural arteries, with mature endothelium, media, and adventitia. Histological analysis revealed that the BSDVG promoted faster tissue regeneration and more organized extracellular matrix (ECM) remodeling, with a positive ECM remodeling and well-organized collagen distribution. Additionally, the BSDVG induced M2 polarization of macrophages, which secrete wound-healing cytokines to promote vascular regeneration. These findings highlight the potential of the BSDVG for clinical applications in small-diameter vascular grafts.This study presents a novel 3D-printed bilayer small-diameter vascular graft (BSDVG) designed to facilitate rapid smooth muscle layer (SML) regeneration and improve vascular function. The inner layer of the BSDVG has larger pore sizes and high porosity to enhance cell infiltration and circumferential alignment, mimicking the natural SML. The outer layer, designed to induce fibroblast recruitment, has smaller pore sizes and denser fiber intersections to provide sufficient mechanical strength. In vivo experiments in rats showed that the BSDVG exhibited better pulsatility and compliance compared to electrospun grafts, with a compliance of 8.9% and a pulsatility approaching that of natural arteries (11.36%). The BSDVG also demonstrated a three-layer structure similar to natural arteries, with mature endothelium, media, and adventitia. Histological analysis revealed that the BSDVG promoted faster tissue regeneration and more organized extracellular matrix (ECM) remodeling, with a positive ECM remodeling and well-organized collagen distribution. Additionally, the BSDVG induced M2 polarization of macrophages, which secrete wound-healing cytokines to promote vascular regeneration. These findings highlight the potential of the BSDVG for clinical applications in small-diameter vascular grafts.