In orthopedics, infectious bone defects face a formidable challenge considering the critical issues of infection control and bone regeneration during treatment. Although numerous biomaterials have been developed for addressing these therapeutic challenges, most of them fail to meet the high regeneration requirements of infectious bone defects with complex pathological environment. There is an urgent need for the rational design of multifunctional bioactive scaffolds that integrate antimicrobial treatment with bone regeneration capabilities. 3D printing, as a powerful manufacturing technique, holds great promise in fabricating complex bone tissue engineering scaffolds with highly personalized customization. The 3D printed bioactive scaffolds possess excellent biocompatibility, outstanding antimicrobial properties, appropriate mechanical strength, and bone regeneration ability, making it a highly attractive emerging strategy for overcoming the challenges of infectious bone defect repair. This review firstly discusses the therapeutic challenges of infectious bone defects and the desirable features of ideal bone implants. It then provides a systematic overview of recent advancements in 3D printing technologies and biomaterials used in the 3D printed bioactive scaffolds for infectious bone defects. Finally, we highlight the advantages, potential breakthroughs, and challenges of 3D printed bioactive scaffolds in repairing infectious bone defects.