This article presents a density‐based topology optimization method for designing three‐dimensional (3D) compliant mechanisms (CMs) and loadbearing structures with design‐dependent pressure loading. Instead of interface‐tracking techniques, the Darcy law in conjunction with a drainage term is employed to obtain pressure field as a function of the design vector. To ensure continuous transition of pressure loads as the design evolves, the flow coefficient of a finite element (FE) is defined using a smooth Heaviside function. The obtained pressure field is converted into consistent nodal loads using a transformation matrix. The presented approach employs the standard FE formulation and also, allows consistent and computationally inexpensive calculation of load sensitivities using the adjoint‐variable method. For CM designs, a multicriteria objective is minimized, whereas minimization of compliance is performed for designing loadbearing structures. Efficacy and robustness of the presented approach is demonstrated by designing various pressure‐actuated 3D CMs and structures.