© 2022. Acta Ortopedica Brasileira. All Rights Reserved.Objective: To evaluate the effect of 3d printed models on surgical pre-operative planning of complex spinal deformities. Methods: In our study, five orthopedic surgeons made surgical planning of 5 patients with severe spinal deformity in three conditions: X-ray with computer tomography (X-ray-CT), 3D-computed tomography (3dCT), and 3d printed spine models. Operation plans were examined according to the level and number of instrumentations, osteotomy level, and time required for decision-making. Results: X-ray-CT, 3dCT, and 3d modeling methods were compared, and no statistically significant difference was observed in the number of screws and osteotomy score to be used in operation. The time required for decision ranking is 3d Model, 3d CT, and Xray-CT. Conclusions: 3d printed models do not influence the operative plan significantly; however, it reduces surgical planning time at pre-op duration, and those models gave some opportunities to practice with implants on a patient’s 3d spine model. Level of Evidence III; Diagnostic Studies - Investigating a Diagnostic Test.