This chapter examines how digital textile printing (DTP) has the potential to offer scalable and sustainable alternatives to conventional fashion and textile production by addressing two key challenges: inefficient overproduction, and consumer behaviour. As mass-produced, low-cost textiles dominate the market, consumers struggle to make sustainable choices. DTP enables on-demand production, facilitating localised supply chains and supporting innovative business models that engage consumers and reduce the risks of mass production. Drawing on a narrative review of sustainable fashion ecosystems and two commercial case studies the chapter seeks to address the role that DTP can play, the barriers to achieving, whilst also considering design-led approaches to drive change. It proposes repositioning DTP as a co-creation tool for customise–print–make–wear. By situating within micro factories and maker spaces this approach offers potential for community regeneration and small-scale economic growth, to support efficient production and behaviour change. However, barriers remain, including limited access to sustainable substrates and colourants, profitability challenges, a lack of knowledge-sharing and lack of proven environmental data. By balancing DTP’s economic and creative potential with a realistic assessment of its limitations, this chapter contributes to the broader discussion on digital manufacturing’s role in ethical and sustainable fashion.