Objective To explore the role of problem-based learning (PBL) combined with case-based learning (CBL) teaching film reading in the standardized training of radiology resident physicians. Methods From March 2023 to August 2024, 102 resident physicians rotated in the Radiology Department of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. A total of 56 resident physicians in 2023 underwent traditional lecture-based learning (LBL) teaching model as the control group. And 46 resident physicians receivied PBL combined with CBL film reading teaching model based on the PACS platform as the experimental group. After the resident physicians’ rotation, an end-of-rotation assessment was conducted, including theoretical assessment, skill operation assessment, and daily assessment. An evaluation and satisfaction survey on teaching modes, instructors, and departments were conducted. IBM SPSS 19.0 statistical analysis software was used to analyze the teaching effects of the two groups. And P <0.05 was considered statistically significant. Results There was no statistically significant difference in gender, age, education level, and degree between the two groups. The theoretical assessment scores of the two groups were (93.18±2.572) and (84.73±7.478), respectively. The skill operation assessment scores were (96.73±1.423) and (90.11 ±3.112), respectively. The daily assessment scores were (76.70 ±1.517) and (70.38 ±2.771), respectively. The difference in scores between the two groups was statistically significant (P<0.001). The scores for the two teaching modes were (49.24 ±1.816) and (45.36 ±1.299), respectively. The teachers’ scores were (99.39 ±1.795) and (98.27 ± 3.621), respectively, and the department’s scores were (99.87±0.653) and (98.79±3.049). The difference in departments’ scores between the two groups was statistically significant (P<0.05). The satisfaction rate of the experimental group was 100%, while that of the control group was 96.4%. There was a statistically significant difference in satisfaction rate between the two groups (P=0.002). Conclusion The PBL combined with CBL film reading teaching model based on the PACS platform has received unanimous praise from radiology rotating resident physicians. It is more conducive to cultivating their logical thinking ability in imaging diagnosis.