Three-dimensional printing (3 Dp) is being increasingly used in medical education. Although the use of such lifelike models is beneficial, well-powered, randomized studies supporting this statement are scarce. Two spinal fracture simulation models were generated by 3 Dp. Altogether, 120 medical students (54.2% females) were randomized into three teaching module groups two-dimensional computed tomography images (CT), 3D, or 3 Dp and asked to answer 10 key anatomical and 4 evaluative questions. Students in the 3 Dp or 3D group performed significantly better than those in the CT group, although males in the 3D group scored higher than females. Students in the 3 Dp group were the first to answer all questions, and there were no sex-related differences. Pleasure, assistance, effect, and confidence were more predominant in students in the 3 Dp group than in those in the 3D and CT groups. This randomized study revealed that the 3 Dp model markedly improved the identification of complex spinal fracture anatomy by medical students and was equally appreciated and comprehended by both sexes. Therefore, the lifelike fracture model made by 3 Dp technology should be used as a means of premedical education.