Objective To investigate the application value of the teaching mode of guided learning interactive (BOPPPS) under the theoretical perspective of outcome-based education (OBE) in the training of spine surgery residents. Methods A total of 60 spine surgery residents in Department of Spine Surgery, the Affiliated Hospital of Youjiang Medical University of Nationalities from August 2022 to August 2024 were selected for analysis, and the 60 residents from August 2022 to August 2023 were included in the control group (traditional teaching method), and the same group of 60 residents from August 2023 to August 2024 were included in the observation group (the BOPPPS teaching mode under the perspective of OBE theory was adopted on the basis of the control group). And the thinking ability, teaching effect, clinical comprehensive ability and teaching satisfaction of the two groups were compared . Results Before teaching, there were no statistically significant difference in the critical thinking disposition inventory-Chinese version (CTDI-CV) scores and clinical comprehensive ability scores of the two groups (all P ＞ 0.05). After teaching, the CTDICV scores and clinical comprehensive ability scores of the observation group were higher than those of the control group (all P ＜ 0.05). The teaching effect (4 scales of analytical ability, theoretical performance, operational performance, and problem solving ability) and teaching satisfaction (5 scales of recognition, teaching attitude, teaching content, teaching environment, and self-improvement of professional quality) scores of the observation group were all higher than those of the control group (all P ＜ 0.05). Conclusion The BOPPPS teaching model under the perspective of OBE theory in the application of spinal surgery residents can improve their clinical comprehensive ability, thinking ability, and enhance the teaching effect and teaching satisfaction.