This study presents a scaffold-free vascular tissue engineering approach using bioprinting to fabricate small-diameter vascular grafts. The method involves the use of multicellular spheroids and cylinders, which are printed layer-by-layer with agarose rods as a molding template. These units are then fused to form single- and double-layered vascular tubes with diameters ranging from 0.9 to 2.5 mm. The technique allows for the creation of vessels with distinct shapes and hierarchical structures, and is rapid, reproducible, and easily scalable. The method avoids the limitations of traditional scaffolds, such as adverse host responses and mechanical mismatch, and provides a high cell density, which is crucial for vascular tissue function. The study also demonstrates the ability to engineer complex vascular structures, including branched and multi-layered tubes, using a fully biological approach. The results show that the method can produce vascular grafts that are readily perfusable and suitable for further maturation. The technique uses a bioprinter to deposit bioink particles, which are then fused through post-printing processes. The use of multicellular cylinders as building blocks allows for more efficient and precise fabrication of vascular structures compared to spheroids. The study highlights the potential of this scaffold-free approach for tissue engineering, particularly in the development of vascular grafts for clinical applications. The method is promising for creating complex vascular structures with precise control over cell arrangement and tissue architecture. The study also addresses challenges such as vascularization in thick tissues and the need for precise cell positioning within the vessel wall. The results indicate that the scaffold-free bioprinting method is a viable alternative to traditional scaffold-based approaches for vascular tissue engineering.This study presents a scaffold-free vascular tissue engineering approach using bioprinting to fabricate small-diameter vascular grafts. The method involves the use of multicellular spheroids and cylinders, which are printed layer-by-layer with agarose rods as a molding template. These units are then fused to form single- and double-layered vascular tubes with diameters ranging from 0.9 to 2.5 mm. The technique allows for the creation of vessels with distinct shapes and hierarchical structures, and is rapid, reproducible, and easily scalable. The method avoids the limitations of traditional scaffolds, such as adverse host responses and mechanical mismatch, and provides a high cell density, which is crucial for vascular tissue function. The study also demonstrates the ability to engineer complex vascular structures, including branched and multi-layered tubes, using a fully biological approach. The results show that the method can produce vascular grafts that are readily perfusable and suitable for further maturation. The technique uses a bioprinter to deposit bioink particles, which are then fused through post-printing processes. The use of multicellular cylinders as building blocks allows for more efficient and precise fabrication of vascular structures compared to spheroids. The study highlights the potential of this scaffold-free approach for tissue engineering, particularly in the development of vascular grafts for clinical applications. The method is promising for creating complex vascular structures with precise control over cell arrangement and tissue architecture. The study also addresses challenges such as vascularization in thick tissues and the need for precise cell positioning within the vessel wall. The results indicate that the scaffold-free bioprinting method is a viable alternative to traditional scaffold-based approaches for vascular tissue engineering.