The invention discloses a medical high abrasion resistance titanium alloy composite and a gradient in-situ nano multiphase abrasion reduction medical titanium alloy 3D printing method. The physical characteristics of boron carbide ceramic and a titanium alloy are combined, a laser selective melting forming process is adopted, and under the effect of high energy lasers, active elements of carbon and boron can be conveniently diffused outwards in a radial gradient mode along boron carbide ceramic particles, and nano ceramic reinforced phases such as Ti-B, TiB2 and TiC can be easily synthesized through the carbon, the boron and the medical titanium alloy. On one hand, forming of a gradient ceramic particle/titanium alloy interface is promoted, and wettability of the gradient ceramic particle/titanium alloy interface is remarkably enhanced; and on the other hand, based on good physical properties and the uniform dispersion strengthening effect of the in-situ synthesis multiphase nano ceramic particles, the friction and abrasion characteristics of the medical titanium alloy can be effectively improved, manufacturing of the high performance medical titanium alloy is achieved, and the medical high abrasion resistance titanium alloy has good clinical application prospects and economic value.