Comparison between The Sims 3 and The Sims Medieval
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The Sims 3 and The Sims Medieval use the same engine, so they may seem somewhat alike, but they are very different games.
The Sims 3
The Sims 3, like previous games in The Sims series, is set in a modern era. While players have always been able to use custom content to simulate a medieval setting, at least to some degree, the games themselves presume a modern society with refrigerators and stoves, computers and telephones, etc.
In The Sims 3, players can design and recolor almost everything in the game. Also, players can go into considerable detail when creating Sims and families.
The Sims Medieval
The Sims Medieval, as its name implies, is designed to simulate a medieval setting. Therefore, it won't have modern intrusions such as carpools, taxicabs, and telephones that would need to be disguised or worked around. Also, the available jobs will have a medieval tone and flavor.
When creating a Sim in The Sims Medieval, the major difference from The Sims 3 is the clothing and hair that is available.
Marriage & Families
In The Sims Medieval, non-selectable Sims do not become selectable when they join a household, even if they marry a selectable Sim. Also, children will not be selectable. (In both cases, they can be made selectable with the use of cheats.) This is a major difference not only from The Sims 3, but The Sims and The Sims 2.