Background: Mandibular tumors are common in oral and maxillofacial surgery. Following tumor resection, significant bone tissue defects often occur, severely compromising both facial appearance and function. Currently, fibular myocutaneous flaps are widely employed by head and neck surgeons to repair various types of mandibular defects. However, accurately restoring the mandibular contour remains a major challenge. To achieve optimal clinical outcomes, we applied digital design and 3D printing technology in conjunction with fibula musculocutaneous flaps for mandibular defect reconstruction. In this study, we present our approach and share the experience gained. Methods: A retrospective review was conducted on 16 patients who underwent mandibular reconstruction between June 2021 and May 2024. All patients had mandibular bone defects following oral tumor resection and were treated using vascularized fibula myocutaneous flaps guided by digital design and 3D printing technology. Results: Flap survival was achieved in 15 patients (93.7%), with 1 case (6.3%) of flap necrosis. During a follow-up period of 6 to 30 months, 1 patient (6.3%) experienced local tumor recurrence. All followed-up patients reported satisfactory outcomes in terms of mouth opening, masticatory function, and facial aesthetics. Conclusion: The integration of digital design and 3D printing technology in mandibular reconstruction using fibula musculocutaneous flaps facilitates accurate anatomical restoration and improves facial symmetry, contributing to favorable clinical outcomes.