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Abstract: The global demand for effective skin injury treatments has prompted exploration of tissue engineering solutions. While threedimensional (3D) bioprinting has shown promise, challenges persist with respect to achieving timely and compatible solu‐ tions to treat diverse skin injuries. In situ bioprinting has emerged as a key new technology, since it reduces risks during the implantation of printed scaffolds and demonstrates superior therapeutic effects. However, maintaining printing fidelity dur‐ ing in situ bioprinting remains a critical challenge, particularly with respect to model layering and path planning. This study proposes a novel optimization-based conformal path planning strategy for in situ bioprinting-based repair of complex skin injuries. This strategy employs constrained optimization to identify optimal waypoints on a point cloud-approximated curved surface, thereby ensuring a high degree of similarity between predesigned planar and surface-mapped 3D paths. Further‐ more, this method is applicable for skin wound treatments, since it generates 3D-equidistant zigzag curves along surface tan‐ gents and enables multi-layer conformal path planning to facilitate treatment of volumetric injuries. Furthermore, the pro‐ posed algorithm was found to be a feasible and effective treatment in a murine back injury model as well as in other complex models, thereby showcasing its potential to guide in situ bioprinting, enhance bioprinting fidelity, and facilitate improvement of clinical outcomes.