Abstract: Carbon fiber reinforced epoxy resin composites (CFRP) show great promise for structural-functional integrated applications in thermal management. Yet their thermal conductivity has long been constrained by interfacial thermal resistance and the limited controllability of reinforcement distribution via conventional molding processes. In this study, multilayer MXene is uniformly dispersed into epoxy resin (EP) via high-speed shear mixing. High-modulus carbon fiber/epoxy composites are fabricated respectively by hot pressing and in-situ 3D printing, allowing a systematic investigation into the effects of the two molding processes on MXene dispersion state as well as mechanical and thermal properties of the composites. The results demonstrate that under hot pressing, MXene tends to locally aggregate between fiber layers, resulting in an interlaminar shear strength (ILSS) of 67.6 MPa and an in-plane thermal conductivity of 35.4 W/(m·K). In contrast, during the 3D printing process, shear flow induces an ordered alignment of MXene along the fiber axis, yielding an ILSS of 76.7 MPa and an in-plane thermal conductivity of 40.4 W/(m·K), which represent increases of 13.5% and 14.1%, respectively, over those of the hot-pressed samples. 3D printing enables simultaneous enhancement of both mechanical load-bearing capacity and thermal conductivity of CFRP by optimizing the oriented distribution of MXene, offering a novel pathway for the advanced manufacturing of structurally and functionally integrated composites.