Over the past two decades, 3D bioprinting has become a popular research topic worldwide, as it is the most promising approach for manufacturing vascularized organs in vitro. However, transitioning from bioprinting of simple tissue models to real biomedical applications is still a challenge due to incomplete interdisciplinary theoretical knowledge and imperfect multi-technology integration. This review examines the goals of vasculature manufacturing and proposes new strategic objectives in three stages. We then outline a bidirectional manufacturing strategy consisting of top-down reconstruction (bioprinting) and bottom-up regeneration (cellular behaviour). We also provide an in-depth analysis of the four aspects of design, ink, printing and culture. Furthermore, we present the 'construction-comprehension cycle' research paradigm and the 'math-model-based batch insights generator' research paradigm for the future, which may have the potential to revolutionize the biomedical field.