This study presents an innovative solution to improve the mechanical performance of traditional cemented tailings backfill (CTB) by incorporating 3D-printed polymer lattice (3DPPL) reinforcements. We systematically investigated three distinct 3DPPL configurations (four-column FC, six-column SC, and cross-shaped CO) through comprehensive experimental methods including Brazilian splitting tests, digital image correlation (DIC), and scanning electron microscopy (SEM). The results show that the 3DPPL reinforcement significantly enhances the CTB’s tensile properties, with the CO structure demonstrating the most substantial improvement—increasing the tensile strength by 85.6% (to 0.386 MPa) at a cement-to-tailings ratio of 1:8. The 3DPPL-modified CTB exhibited superior ductility and progressive failure characteristics, as evidenced by multi-stage load-deflection behavior and a significantly higher strain capacity (41.698–51.765%) compared to unreinforced specimens (2.504–4.841%). The reinforcement mechanism involved synergistic effects of macroscopic truss behavior and microscopic interfacial bonding, which effectively redistributed the stress and dissipated energy. This multi-scale approach successfully transforms CTB’s failure mode from brittle to progressive while optimizing both strength and toughness, providing a promising advancement for mine backfill material design.