Additive manufacturing (AM) has transformed the field of metallic bone implants by enabling the production of patient-specific, biomimetic, and high-performance devices. This review focuses on the personalized design of bone implants using AM technologies, particularly selective laser melting (SLM) and electron beam melting (EBM), and their capacity to fabricate complex lattice structures that replicate the trabecular architecture of native bone. These architectures enhance load transfer, reduce stress shielding, and promote osseointegration. The review also explores current strategies and digital tools for biomimetic design, as well as numerical simulation methods, including finite element analysis (FEA), computational fluid dynamics (CFD), and multi-field coupling models, used to optimize implant geometry, porosity, and mechanical performance. Furthermore, it synthesizes recent clinical and preclinical data evaluating in vivo functionality, biological integration, and the latest advancements in the optimization of personalized bone implant design. Altogether, the work provides a comprehensive roadmap for researchers and clinicians engaged in implant innovation and skeletal tissue repair.