Hard tissue engineering has been transformed by the combination of smart biomaterials and additive manufacturing methods, opening up new possibilities for regenerative medicine. With an emphasis on additive manufacturing, this chapter offers a thorough review of sophisticated smart biomaterials and constructions used in hard tissue engineering. It covers the basics of smart biomaterials and how they are used to regenerate hard tissues like cartilage and bone. Smart biomaterials are materials that can react to external impetus including mechanical forces, temperature, and pH. To replicate the natural tissue milieu, intricate structures requiring exact control over shape and porosity are made possible using additive manufacturing. Scaffolds that facilitate cell attachment, proliferation, and differentiation are made using a variety of processes, such as stereolithography, selective laser sintering, and extrusion-based printing. To improve their regeneration qualities, these scaffolds are frequently packed with intelligent biomaterials like hydrogels, nanoparticles, and growth factors. Recent developments in the subject are highlighted in this chapter, including the creation of bioactive scaffolds that can promote tissue growth and healing. Additionally, it talks about how additive manufacturing procedures can be used to manufacture patient-specific implants that will improve treatment outcomes by utilizing imaging techniques like computed tomography (CT) and magnetic resonance imaging (MRI). The use of smart biomaterials for drug delivery is also explored in this chapter, allowing for the regulated release of therapeutic substances to support tissue regeneration. Even with these developments, there are still issues to be resolved, such as the need for better smart biomaterials’ mechanical and biocompatibility qualities as well as the scalability and affordability of additive printing methods. In order to advance the area and integrate these technologies into clinical applications, it will be imperative to tackle these obstacles.