Abstract: High-precision point cloud anomaly detection is the gold standard for identifying the defects of advancing machining and precision manufacturing. Despite some methodological advances in this area, the scarcity of datasets and the lack of a systematic benchmark hinder its development. We introduce Real3D-AD, a challenging high-precision point cloud anomaly detection dataset, addressing the limitations in the field. With 1,254 high-resolution 3D items (from forty thousand to millions of points for each item), Real3D-AD is the largest dataset for high-precision 3D industrial anomaly detection to date. Real3D-AD surpasses existing 3D anomaly detection datasets available in terms of point cloud resolution (0.0010mm-0.0015mm), $360^{\circ}$ degree coverage and perfect prototype. Additionally, we present a comprehensive benchmark for Real3D-AD, revealing the absence of baseline methods for high-precision point cloud anomaly detection. To address this, we propose Reg3D-AD, a registration-based 3D anomaly detection method incorporating a novel feature memory bank that preserves local and global representations. Extensive experiments on the Real3D-AD dataset highlight the effectiveness of Reg3D-AD. For reproducibility and accessibility, we provide the Real3D-AD dataset, benchmark source code, and Reg3D-AD on our website: https://github.com/M-3LAB/Real3D-AD.