3D printing is redefining pharmaceutical manufacturing by enabling personalized medicine tailored to individual patient needs. Traditional drug production relies on standardized dosages designed for the average patient, often overlooking inter-individual differences in age, metabolism and disease characteristics. In contrast, 3D printing allows for the fabrication of patient-specific dosage forms, implants and drug delivery systems with precise control over drug release, geometry and composition. This review highlights key 3D printing technologies including extrusion-based methods, stereolithography and selective laser sintering and their role in advancing personalized therapeutics. The integration of nanotechnology further enhances functionality, enabling smart, targeted drug delivery with reduced side effects. Multi-material printing allows combination therapies within a single unit, improving patient adherence. Despite its promise, challenges such as material compatibility, scalability, dose uniformity and regulatory approval remain significant barriers to widespread clinical adoption. Process Analytical Technology (PAT) and real-time quality control tools are emerging to address these issues, alongside efforts to develop GMP-compliant systems. By examining fabrication methods, clinical applications and regulatory landscapes, this review provides a comprehensive overview of the current state and future potential of 3D printing in pharmaceuticals. With continued innovation, it promises to transform personalized medicine through safer, more effective and accessible therapies. © 2025 Elsevier B.V., All rights reserved.