This review summarizes the current research on 3D printed osteochondral (OC) scaffolds, focusing on design strategies, applications, and future perspectives. OC defects, characterized by cartilage and subchondral bone loss, are challenging to treat with traditional methods. 3D printing offers a promising solution by enabling precise, customizable scaffolds that mimic the gradient structure of natural OC tissue. The review highlights the importance of material selection, structural design, and seed cell integration in developing effective OC scaffolds. Natural and synthetic polymers, inorganic materials, metals, and composites are discussed as potential scaffold materials, each with unique advantages and limitations. The review also covers various 3D printing technologies, including powder-based, fiber filament-based, liquid-based, and light-based methods, and their applications in creating scaffolds with gradient structures. Biphasic and triphasic scaffolds are emphasized for their ability to simulate the complex architecture of OC tissue, with examples of scaffolds designed for simultaneous bone and cartilage repair. The review concludes that 3D printing technology holds great potential for advancing OC tissue engineering, but further research is needed to optimize scaffold design and improve clinical outcomes.This review summarizes the current research on 3D printed osteochondral (OC) scaffolds, focusing on design strategies, applications, and future perspectives. OC defects, characterized by cartilage and subchondral bone loss, are challenging to treat with traditional methods. 3D printing offers a promising solution by enabling precise, customizable scaffolds that mimic the gradient structure of natural OC tissue. The review highlights the importance of material selection, structural design, and seed cell integration in developing effective OC scaffolds. Natural and synthetic polymers, inorganic materials, metals, and composites are discussed as potential scaffold materials, each with unique advantages and limitations. The review also covers various 3D printing technologies, including powder-based, fiber filament-based, liquid-based, and light-based methods, and their applications in creating scaffolds with gradient structures. Biphasic and triphasic scaffolds are emphasized for their ability to simulate the complex architecture of OC tissue, with examples of scaffolds designed for simultaneous bone and cartilage repair. The review concludes that 3D printing technology holds great potential for advancing OC tissue engineering, but further research is needed to optimize scaffold design and improve clinical outcomes.