This paper introduces a design and rapid manufacturing method of customized skull patches based on 3D printing. This method is mainly by collecting the CT images that lesions bones of cerebral cranium, and then gain 3D model by use the Mimics software. find the skull surface that need to optimized by use symmetrical mirror image method, Use the rhino software to build models and test and repair the model by loading it to the Magics software. Save the model for the STL file, finally, print out the customized skull patches by 3D printer, In this way we can realize the customized skull patches design and rapid manufacturing.