Nineteen randomized controlled trials including 1046 patients with acetabular fractures were included in this systematic review and meta-analysis comparing 3D printing-assisted open reduction and internal fixation (ORIF) vs. conventional ORIF. Pooled outcomes of interest included intraoperative blood loss, operation time, instrumentation time, intraoperative fluoroscopy, post-surgery Matta score, Harris score, time from injury to operation, and complication rates. The meta-analysis found significant reductions in blood loss, operation time, fluoroscopy, and complication rates in the 3D printing group, along with improved fracture reduction quality, but no difference in Harris scores or surgical delay. These findings suggest that 3D printing-assisted ORIF may enhance surgical efficiency and safety without delaying treatment.