Objective To observe the effects of using problem-based learning (PBL) and lecture-based learning (LBL) in clinical teaching in emergency intensive care unit (EICU).Methods Three hundred and twelve 5-year clinical medicine undergraduates from Xinjiang Medical University including 108 students in 2007 class and 204 students in 2008 class were enrolled. The students in each class were randomly divided into two groups, 54 students in each group in 2007 class and 102 students in each group in 2008 class. Randomized controlled trial was conducted; in the first half of a semester, the students in the two groups of each class were taught by PBL method and LBL method respectively. At the middle of the semester, written examination (WES), objective structure clinical examinations (OSCE) and self assessment questionnaire test were carried out to evaluate students' learning effect. In the second half of the semester, the teaching method in the two groups of each class was exchanged, and at the end of the semester, the same examinations were carried out, and the examination and questionnaire scores in the two groups of each class were compared.Results The results of comparisons of the WES and OSCE scores between two modes in each class showed that the scores of WES and OSCE of the PBL mode were obviously higher than those in the LBL mode (the first half of semester in 2007 class: WES: 23.20±3.33 vs. 22.78±4.41, OSCE: 27.60±6.44 vs. 25.45±6.35, in 2008 class: WES: 24.45±2.65 vs. 23.02±3.67, OSCE: 29.53±4.67 vs. 27.57±6.83, in the second half of the semester in 2007 class: WES: 24.60±3.67 vs. 23.46±2.57, OSCE: 28.50±4.78 vs. 28.01±5.78, in 2008 class: WES: 23.54±3.56 vs. 22.56±6.89, OSCE: 28.08±2.15 vs. 27.43±7.23,P < 0.05 orP < 0.01). The score results of self assessment questionnaires of students in two groups of 2007 class and 2008 class showed that the self learning ability, initiative, linking theory with practice, team power and attentiveness were significantly higher in the PBL teaching mode than those in the LBL teaching mode [the first half of the semester in 2007 class: self learning ability (score): 4.20±0.67 vs. 3.32±0.71, the initiative (score): 4.15±0.98 vs. 2.01±0.81, linking theory with practice (score): 4.09±0.65 vs. 3.52±0.89, team power (score): 4.43±0.56 vs. 3.08±0.43, attentiveness (score): 4.25±0.77 vs. 2.98±0.67; the second half of the semester in 2007 class: self learning ability (score): 4.23±0.77 vs. 2.11±0.98, the initiative (score): 4.59±0.85 vs. 3.20±0.73, linking theory with practice (score): 4.23±0.71 vs. 2.88±0.87, team power (score): 4.66±0.63 vs. 2.21±0.64, attentiveness (score): 4.21±0.73 vs. 2.28±0.43; the first half of the semester in 2008 class: self learning ability (score): 7.60±0.64 vs. 5.62±0.41, the initiative (score): 7.23±0.47 vs. 5.07±0.51, linking theory with practice (score): 7.04±0.67 vs. 4.56±0.59, team power (score): 7.33±0.55 vs. 5.06±0.47, attentiveness (score): 6.21±0.87 vs. 4.88±0.37; the second half of the semester in 2008 class: self learning ability (score): 7.03±0.71 vs. 5.11±0.48, the initiative (score): 7.89±0.57 vs. 5.20±0.33, linking theory with practice (score): 7.63±0.25 vs. 4.88±0.57, team power (score): 7.64±0.33 vs. 5.21±0.67, attentiveness (score): 7.01±0.89 vs. 6.01±0.90].Conclusion PBL method of teaching is worthwhile to be explored and spread extensively, especially in medicine, a scientific course involving much attention on practice, it embodies more importance.