Purpose Treatment of tibial plateau fractures are difficult due to the intra-articular nature of the proximal tibia and extensive involvement of the soft tissue envelope. In this study, we investigated the surgical experience acquired using digitally designed life-size fracture models to guide as a template to place plates and screws in the treatment of tibial plateau fractures and anatomic reduction of joint. Methods 20 tibial plateau frature patients were divided into two equal surgery groups as conventional versus 3D model assisted. The fracture line angles, depression depth, and preoperative/postoperative Rasmussen knee score were measured for each patient. Results The duration of the operation, blood loss volume, turniquet time and number of intraoperative fluoroscopy was 89.5 +/- 5.9 min, 160.5 +/- 15.3 ml, 74.5 +/- 6 min and 10.7 +/- 1.76 times, for 3D printing group and 127 +/- 14.5 min, 276 +/- 44.8 ml, 104.5 +/- 5.5 min and 18.5 +/- 2.17 times for the conventional group, respectively. 3D model-assisted group indicated significantly shorter operation time, less blood loss volume, shorter turniquet and fluoroscopy times, and better outcome than the conventional one. Conclusions The customized 3D model was user friendly, and it provided a radiation-free tibial screw insertion. The use of these models assisted surgical planning, maximized the possibility of ideal anatomical reduction and provided individualized information concerning tibial plateau fractures.