Provided are methods and apparatuses for navigation guidance and establishing a three-dimensional real scene model, a device and a medium, which relate to the field of artificial intelligence and, in particular, intelligent transportation technologies. A specific implementation includes: determining a navigation route of a navigation device and candidate three-dimensional real scene data corresponding to the navigation route; where the candidate three-dimensional real scene data includes candidate location information, candidate three-dimensional model data and a candidate observation viewing angle; matching real-time positioning information of the navigation device with the candidate location information in the candidate three-dimensional real scene data to obtain target three-dimensional real scene data; and simulating target three-dimensional model data in the target three-dimensional real scene data at a target observation viewing angle in the target three-dimensional real scene data and at a location corresponding to the real-time positioning information to obtain a real-time navigation guidance image.