Direct 3D-printed clear aligners represent an emerging paradigm in digital orthodontics, challenging the long-standing dominance of thermoformed aligners. This article examines the technology through a balanced clinical and commercial lens. While direct-printed resins currently face limitations in mechanical strength and biocompatibility compared to multi-layer polymer sheets, recent material innovations—such as LuxCreo’s ActiveMemory™ polymer and Graphy’s Tera Harz TC-85 shape-memory resin—are progressively closing this performance gap. The transformative advantage lies in chairside workflow efficiency: intraoral scanning, AI-based design, and direct printing can compress traditional 5–10-day turnaround into a 2–3-hour same-day delivery model. Design freedom enables full-area variable thickness, integrated functional components, and attachment-free mechanics impossible with thermoforming. The market landscape is diversifying beyond early movers LuxCreo and Graphy to include SprintRay, VOXELTEK, and SHINING 3D, though truly regulatory-cleared direct-printing systems remain limited. Clinically, the most mature application is early childhood orthodontics, where light-force functional guidance, high compliance demands, and frequent aligner replacement align perfectly with chairside same-day production capabilities.