The aim of this work is the design of a new customised elbow orthosis completely realized by Additive Manufacturing and the development of generative algorithms for parametric modelling and creation of 3D patterns to be adapted to the CAD model. This work describes a method to perfect the design of a custom elbow orthosis. A reverse engineering approach has been used to digitalize the patient’s arm and the subsequent CAD modelling of the structure of the custom elbow orthosis has been performed. In particular, two algorithms have been implemented for the creation of 3D patterns and Voronoi tessellations. Subsequently, FEM analyses have been carried out to validate the design. Finally, a prototype of the elbow orthosis with Voronoi tessellation has been realized by means of the SLS technology. The results obtained have demonstrated that the implemented algorithm solved the problems found during CAD modelling with conventional software. Furthermore, the results of FEM analyses have validated the design choices. All this allowed realizing the prototype by AM technologies without problems. Moreover, the new proposed modelling approaches allows creating, in an interactive way, patterns on complex surfaces. The results of this research activity present innovative elements of originality in the CAD modelling sector, which can contribute to solving problems related to the modelling for Additive Manufacturing. Furthermore, another innovative characteristic of the device is the use of torsion springs that simulate the action of physiotherapists during exercises for patient rehabilitation.