Diabetic foot ulcers (DFUs) are the evidence-dominant neuroischemic target for this review. Non-diabetic chronic limb-threatening ischemia (CLTI) tissue loss and selected post-revascularization or post-debridement arterial defects are included only as ischemic adjacent cohorts, because neuropathy cannot be assumed outside diabetes. Across these groups, perfusion failure, infection risk, persistent inflammation and extracellular-matrix failure compromise the wound bed; neuropathy and neuroimmune dysfunction are defining modifiers primarily in DFU. Three-dimensional bioprinting may help spatially position cells, bioinks and soluble cues for vascular, epithelial, immune and neural support, but current evidence is mainly preclinical and DFU-focused. This narrative review differs from platform- or material-centered reviews by organizing the evidence around vascular assessment, revascularization, infection source control, wound-bed preparation, offloading and limb-salvage endpoints. We define a four-level vascular evidence hierarchy, match candidate materials and payloads to specific wound scenarios, map diabetic molecular injury pathways to measurable design variables and classify predictable failure modes by evidence type. The resulting decision and translational pathways are proposed research heuristics, not clinically validated algorithms. Current evidence supports feasibility, mechanism selection and disease-matched study design; it does not establish clinical limb-salvage efficacy for printed constructs.