Purpose: To analyze the practical effect of applying step-by-step case teaching in gastroenterology ward rounds. Methods: 72 clinical medical students interned in the Gastroenterology Department of our hospital from February to October 2023 were divided into the control group and the observation group according to the mean score method, with each group having 36 students. The control group adopted the traditional clinical teaching mode and the observation group implemented the step-by-step case teaching mode. The teaching effect and teaching method were evaluated through the theoretical knowledge test, the clinical skills examination, and the teaching method recognition survey after the end of the teaching. Results: Students in the observation group scored higher than those in the control group in the examination of theoretical knowledge and clinical skills in gastroenterology (P < 0.05); students in the observation group recognized the step-by-step case teaching method more than those in the control group in terms of improving motivation and initiative in learning, consolidating theoretical knowledge, improving clinical skills, and fostering team spirit and clinical thinking (P < 0.05). Conclusion: The application of step-by-step case teaching in gastroenterology ward rounds can significantly enhance students’ learning motivation, enable students to have a deeper understanding of the basic theories of gastroenterology, and better master the practical skills of history taking, physical examination, diagnosis, and the development and implementation of treatment plans in gastroenterology, which is worth to be widely used in clinical education.