BACKGROUND: Three-dimensional (3D) printing is an evolving technology that has been used recently in a wide spectrum of applications. AIM: The objective is to evaluate the application of 3D printing in various neurosurgical practice. PATIENTS AND METHODS: This pilot study was conducted in the neurosurgical hospital in Baghdad/Iraq between July 2018 and July 2019. An X, Y, and Z printer was used. The working team included neurosurgeons, biomedical engineers, and bio-technicians. The procedure starts with obtaining Magnetic resonance imaging (MRI) or computed tomography (CT) scan in particular protocols. The MRI, and CT or angiography images were imported into a 3D programmer for DICOM images called 3D slice where these files converted into a 3D pictures. Next, the neurosurgeon determines the cut section he needs to print. The final required object is exported to the X, Y, Z printing software where the technician starts to print it out. The final prototype delivered to the neurosurgeon. He uses it intraoperatively to have an apparent actual size 3D representation of the actual lesion with nearby healthy tissues to have a good idea about the case they manages. RESULTS: This pilot study was applied in three major projects: brain tumors (ten cases), cerebral aneurysms (nine cases), and spine surgery (14 cases). CONCLUSION: Three-dimensional printing has excellent advantages in neurosurgical practice. It can replace many other recent modalities. It enables the neurosurgeon works with more precision, less time-consuming, less cost, and less radiation exposure.