Background: Case based learning (CBL), is a learning method aids learner to reorganize, elaborate their information and provide connection between current and new information. Moreover CBL is student centered, taken in small groups where teacher acts as facilitator or guide. This study was planned to perceive the need for initiating CBL, this study aimed to compare the biochemistry teaching among rst year medical students with that of traditional teaching. Methods This is an observational study conducted from August 2021 to December 2021. This research study was conducted on 99 students of First year MBBS students. Ten ideal case scenarios on the topic of protein energy malnutrition(PEM) in children and acid base balance were prepared, and pre validated by the faculty of Biochemistry, Paediatrics and Surgery medical education department in our institution. CBL was introduced and total three sessions were conducted and compared with traditional teaching. Results The mean (±SD) value of the score of gain in knowledge was 3.90±1.86 (n=99) for the batch of students who attended case based learning while the mean (±SD) gain in knowledge for the batch who underwent, traditional learning ( TL) was 2.60±2.29 (n=99). A paired t-test comparing didactic lectures with self-directed learning showed that the scores following didactic lectures were more compared to SDL and the results were statistically signicant. An unpaired t-test comparing case based learning to SDL also showed statistically signicant gain in knowledge following didactic lectures. Conclusion This study clearly showed that CBL is more effective over traditional teaching for our rst year MBBS students and for covering a wider area.