The article reviews the application of 3D printing technology in the repair of articular osteochondral (OC) defects, which are characterized by the loss of full-thickness articular cartilage and underlying calcified cartilage. Current surgical treatments can relieve pain but cannot fully restore the original function of the OC unit. 3D printing offers a promising solution with its advantages of fast speed, high precision, and personalized customization. The review covers the development of 3D printed OC scaffolds, including material types, fabrication techniques, structural design, and seed cells. It highlights the importance of simulating the gradient structure of subchondral bone and cartilage, emphasizing the need for further research on OC structure and the role of 3D printing in tissue engineering. The article also discusses the classification and characteristics of discrete and continuous gradient scaffolds, and their applications in OC interface regeneration. Finally, it outlines the progress and future prospects of 3D printing technology in OC reconstruction, aiming to improve the repair of OC defects.The article reviews the application of 3D printing technology in the repair of articular osteochondral (OC) defects, which are characterized by the loss of full-thickness articular cartilage and underlying calcified cartilage. Current surgical treatments can relieve pain but cannot fully restore the original function of the OC unit. 3D printing offers a promising solution with its advantages of fast speed, high precision, and personalized customization. The review covers the development of 3D printed OC scaffolds, including material types, fabrication techniques, structural design, and seed cells. It highlights the importance of simulating the gradient structure of subchondral bone and cartilage, emphasizing the need for further research on OC structure and the role of 3D printing in tissue engineering. The article also discusses the classification and characteristics of discrete and continuous gradient scaffolds, and their applications in OC interface regeneration. Finally, it outlines the progress and future prospects of 3D printing technology in OC reconstruction, aiming to improve the repair of OC defects.