Aim <p>This study aimed to determine the clinical and radiographic efficacy of custom-made 3D PEEK plates in comparison with 3D titanium plates for the management of mandibular angle fractures.</p> Patients and methods <p>Eighteen patients with recent mandibular angle fractures indicated for open reduction and internal fixation were randomly allocated into two groups. The study group (<i>n</i> = 9) underwent fixation with custom-made 3D PEEK plates, while the control group (<i>n</i> = 9) received prebent 3D titanium plates adapted on virtually reduced models. Primary outcomes were bite-force recovery and bone-density (Hounsfield units, HU) at the fracture line measured on CT immediately post-op and at 12&#xa0;weeks. Secondary outcomes included operative time, occlusion, interfragmentary stability and wound healing.</p> Results <p>By the end of follow-up, Bite force increased significantly over time in both groups (<i>p</i> &lt; 0.001) with no between-group differences at any time point. Mean bone density increased from 811.1 ± 68.2 HU to 1225.1 ± 111.7 HU in the PEEK group and from 809.0 ± 62.1 HU to 1248.3 ± 92.3 HU in the titanium group (<i>p</i> &lt; 0.001); between-group differences were not significant. Operative time, occlusion outcomes and wound healing were similar between both groups.</p> Conclusion <p>Custom-made 3D PEEK plates achieved comparable clinical, radiographic, and functional outcomes to 3D titanium plates, suggesting that PEEK is a viable alternative for mandibular angle fracture fixation.</p> Trial registration <p>Trial registered at (ClinicalTrials.gov/NCT07156812/2025–08-28).</p>