Metal-based additive manufacturing has gained significant attention in the field of medical implants over the past decade. The application of 3D-printing technology in medical implants offers several advantages over traditional manufacturing methods, including increased design flexibility for implant customization, reduced lead time for emergency cases, and the ability to create complex geometry shapes for patient-specific implants. In this review study, the working principles and conditions of metal 3D-printing technologies such as selective laser sintering, selective laser melting, and electron beam melting, as well as their applications and advantages in the medical field, are investigated in detail. The application scenarios and research status of non-degradable metals including titanium alloy, medical stainless steel, etc., and degradable metals like magnesium alloy are introduced as printing materials. We discuss the improvement of mechanical properties and biocompatibility of implants through surface modification, porous structure design, and the optimization of molding processes. Finally, the biocompatibility issues and challenges caused by the accuracy of CT imaging, fabrication, implant placement, and other aspects are summarized.