In the rehabilitation engineering area, the pressure ulcer prevention is an important and healthy problem, especially for people with the spinal cord injured (SCI). This paper aim to develop a computer aided design and computer aided manufacture (CAD/CAM) method to manufacture custom cushions to prevent pressure ulcer. A patient’s buttock was digitized using 3D laser scanner, and the captured buttock data was processed in reverse engineering environment to generate the 3D surface model of the buttock. The 3D surface model of the buttock is imported into Unigraphics software to create the solid model; then, a flat rectangle that represents the cushion was generated under the buttock to create the buttock-cushion system. Based on the load-deformation relation of cushion materials acquired by the test, the depth of cut of the cushion was established and a CAD model of cushion shape was created through a Boolean subtraction. The CAD model of the contour is post-processed into code that the numerically controlled milling machine (CNC milling) can use to machine the cushion.