<p>Vaginal disorders in reproductive‑age women, including bacterial vaginosis (affecting 23–29%), endometriosis, etc., are increasing alarmingly day by day worldwide. Vaginal drug delivery (VDD) has garnered notable attention in the pharmaceutical field for the localized and systemic treatment of several hormonal and gynaecological conditions. Conventional treatments remain inadequate due to high relapse rates, local and systemic side effects, compliance, invasiveness, drug resistance, adherence, safety, etc. Additive manufacturing, particularly 3D Printing (3DP), is reshaping pharmaceutical sciences by enabling the fabrication of personalized and novel drug delivery solutions. In addition, 3D Printed VDD systems (VDDS) offer highly customized and patient-specific dosage forms that possess controlled release kinetics and precise control over drug deposition, ultimately leading to increased patient adherence. This review comprehensively examines the state-of-the-art in 3DP technologies and critical considerations such as material selection, impact on drug release mechanisms, mechanical properties, and biocompatibility of the formulations, current regulatory landscape, and future perspectives of 3DP in VDD. This eventually paves the way for better patient-centered therapeutic solutions.</p> Graphical Abstract <p></p>