Biofabrication is the generation of biologically functional products from living cells and biomaterials through bioprinting and subsequent maturation processes. Technological and scientific domains are underlying biofabrication ranging from biology to automated manufacturing and culture systems. Among its application domains, Tissue Engineering and Regenerative Medicine poses strict quality requirements for biofabrication, requiring fast and disruptive innovation for processes and products to comply. Innovation in biofabrication is slow and incremental, relying on R&D processes that are inefficient (slow, risky, and costly), ineffective (products have sub-optimal quality), and challenging to replicate. While automation and digitalization support process execution, design, and innovation, they often work as tools for empirical, problem-specific, and operator-dependent approaches. On the other hand, computational approaches support biofabrication process modeling, design, and optimization of experimental activity to improve the quality of processes and products. To express their full potential, computational methods must factor in the biological complexity underlying biofabrication. This review analyzes computational approaches to biofabrication process modeling, design, and optimization with a focus on solutions explicitly accounting for biological complexity.