The high heterogeneity and complex cellular interactions within the tumor microenvironment (TME) pose a fundamental challenge to both cancer research and drug development. Conventional in vitro models fail to faithfully recapitulate the pathological features of tumors, thereby limiting the translation of basic research findings into clinical practice. Although patient-derived tumor organoids preserve the genetic and structural hallmarks of primary tumors, they are inherently constrained by limited control over spatial cellular organization, insufficient recapitulation of the biomimetic microenvironment, and a lack of model standardization. Three-dimensional (3D) bioprinting, characterized by precise spatial manipulation and multi-material deposition, offers a transformative strategy to address these limitations by converting key TME variables into programmable design parameters. Through the rational design of bioinks and optimization of printing parameters, bioprinting enables the programmable patterning of cells, extracellular matrix components, and bioactive factors, substantially enhancing the structural reproducibility, physiological relevance, and functional integrity of tumor organoids. This review systematically summarizes recent advances in bioprinted tumor organoids, with a focus on mainstream bioprinting technologies, the regulation of key process parameters, bioink design strategies for TME reconstruction, and the complete pipeline of organoid fabrication. We further delineate the translational impact of these models across personalized medicine, high-throughput drug discovery, immunotherapy evaluation, and the mechanistic dissection of drug resistance. We also discuss the current challenges in technical reproducibility, scalable manufacturing, ethical governance, and regulatory compliance. Finally, we outline future directions, including multimodal technological integration, four-dimensional (4D) bioprinting, tumor-on-a-chip platforms, and interdisciplinary innovation. Collectively, the convergence of bioprinting and tumor organoid technologies offers a robust platform for constructing highly biomimetic tumor models, dissecting tumor biology, and advancing precision oncology. This programmable reconstruction paradigm may help bridge the gap between basic cancer research, preclinical drug testing, and clinically actionable decision-making.