Objective: To compare the effectiveness of TBL (Team based learning) with LBL (Lecture based learning) in cardiothoracic surgery teaching. Methods: Select 68 fourth-grade clinical probationer students in the cardiothoracic surgery and sort the students according to the results of previous last exam; then all the students were assigned to TBL group (n=34) and LBL group (n=34) in term of their order. At the end of the course, the scores of theoretical knowledge and practical ability were compared and the questionnaire was used to evaluate the effect of TBL and LBL. Results: The scores of TBL were higher than LBL in theoretical knowledge (P = 0.018) and practical ability (P = 0.014). The questionnaire revealed that, compared to LBL, TBL has obvious advantages in terms of facilitating pre-lesson preparation (P<0.001), improving learning motivation and exercising logical thinking ability (P<0.001), stimulating classroom learning atmosphere (P<0.001), promoting teamwork (P<0.001), improving the ability to solve clinical problems (P=0.013), and increasing the understanding of difficult problems (P<0.001); however, there was no significantly different in the promotion of learning theoretical knowledge between the two groups (P=0.633). Conclusions: Compared to LBL, TBL has obvious advantages in theoretical knowledge and practical ability. The questionnaire revealed that most of the students accepted the TBL pedagogy.