To establish a new three-dimensional (3D) digital design method for osteotomy and assess its application value in the surgical treatment of hemivertebrae. Preoperative 3D digital designs for osteotomy of the hemivertebrae were performed, which included computer simulation of the osteotomy and the internal fixation process, and computer-assisted design (CAD) of the templates for osteotomy of the hemivertebrae, pedicle screw positioning, and internal fixation rods. Template-guided osteotomy of the hemivertebrae plus pedicle screw and rod internal fixation were accurately implemented. The preoperative use of this new computer-aided 3D digitized and paperless surgical design can improve the safety, accuracy, and operative time for osteotomy in the treatment of hemivertebrae.