Objective To explore the early use of three dimensional (3D) printing fingerboard to prevent finger spasm in the stroke patients and its rehabilitation effect. Methods Totally 90 cases of the stroke patients with hand dysfunction were divided into 3 groups according to random single-blind method, which included 3D printing group, traditional group and control group. They were treated with personalized 3D printing finger splint, traditional finger splint from factory mass production and conventional good limb positioning. Before starting treatment and after 3 months treatment, the patients’ surface electromyography(sEMG), passive root-mean-square(RMS) value of flexor finger group, modified Ashworth scale (MAS), Fugl-Meyer assessment upper extremity (FMA-UE), range of motion (metacarpal, proximal interphalangeal, distal interphalangeal), and modified Barthel index (MBI) were assessed. Results A total of 86 patients completed the study, and the age range were 59-79 (70.92±4.75) years, including 29 cases in 3D printing group, 28 cases in traditional group, and 29 cases in control group. The passive RMS value of finger flexor group, hand MAS rating, FMA-UE and MBI of 3 group patients were significantly different from those before treatment(all P<0.001). The joint range of motion of 3 group patients (march finger, proximal finger, far finger) had no statistical difference before and after treatment (all P>0.05). After 3 months treatment, the passive RMS, MAS, FMA-UE and MBI indexes of the finger flexors of 3 groups were statistically different(all P<0.05). Comparison among groups, the 3D printing group was better than traditional group and control group(both P<0.05); but there was no statistical difference in the range of motion among 3 group patients (P>0.05). Conclusions Early use of 3D printed fingerboards can effectively prevent increasing of finger muscle tension and spasm in the stroke patients, promote recovery of upper limbs motor functions, and improve patients’ activities of daily living.