This paper introduces Med-DDPM, an innovative solution using diffusion models for semantic 3D medical image synthesis, addressing the prevalent issues in medical imaging such as data scarcity, inconsistent acquisition methods, and privacy concerns. Experimental evidence illustrates that diffusion models surpass Generative Adversarial Networks (GANs) in stability and performance, generating high-quality, realistic 3D medical images. The distinct feature of Med-DDPM is its use of semantic conditioning for the diffusion model in 3D image synthesis. By controlling the generation process through pixel-level mask labels, it facilitates the creation of realistic medical images. Empirical evaluations underscore the superior performance of Med-DDPM over GAN techniques in metrics such as accuracy, stability, and versatility. Furthermore, Med-DDPM outperforms traditional augmentation techniques and synthetic GAN images in enhancing the accuracy of segmentation models. It addresses challenges such as insufficient datasets, lack of annotated data, and class imbalance. Noting the limitations of the Frechet inception distance (FID) metric, we introduce a histogram-equalized FID metric for effective performance evaluation. In summary, Med-DDPM, by utilizing diffusion models, signifies a crucial step forward in the domain of high-resolution semantic 3D medical image synthesis, transcending the limitations of GANs and data constraints. This method paves the way for a promising solution in medical imaging, primarily for data augmentation and anonymization, thus contributing significantly to the field.