The pronounced spatial heterogeneity and dynamic evolution of the tumor microenvironment represent key factors limiting the sustained therapeutic efficacy of anti-tumor drugs in solid tumors. Traditional drug delivery strategies often rely on spatiotemporally uniform delivery profiles, making it difficult to match the complex structural organization and continuously evolving biological states within tumor tissues. This results in uneven drug distribution, limited therapeutic windows, and the development of drug resistance. In recent years, 3D-printing and bioprinting technologies, as layer-by-layer manufacturing methods based on digital design, have provided new solutions for constructing drug delivery systems with modifiable structures, partitioned spatial organization, and programmable time-release capabilities. By precisely controlling the arrangement of materials, bioactive molecules, and cells in three-dimensional space, these systems can not only achieve fine spatiotemporal regulation of the drug delivery process but also integrate cells, extracellular matrix, and mechanical cues during delivery, thereby partially reshaping the tumor microenvironment. This paper systematically reviews the design strategies and latest advancements of 3D-printing and bioprinting delivery systems in achieving spatiotemporally controllable drug delivery within the tumor microenvironment, focusing on their advantages in spatial regulation, temporal response, and tumor microenvironment reprogramming, while analyzing the current key challenges and clinical translation prospects, aiming to provide references for the rational design of next-generation tumor delivery systems.