Objective To explore the application effects of artificial intelligence (AI) -assisted case teaching in neurosurgery clinical internship teaching, and to provide practical evidence for optimizing the neurosurgery internship teaching model and improving the quality of internship. Methods Thirty-three students majoring in clinical medicine who were enrolled in the five-year program and interned in the neurosurgery department of Tongji Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 2024 to December 2024 were selected as the control group. Another thirty-three majoring in clinical medicine who were enrolled in the five-year program and interned in the neurosurgery department of Tongji Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 2025 to December 2025 were selected as the observation group. The control group adopted the traditional clinical internship teaching model, while the observation group adopted the AI-assisted case teaching model. After the internship, the theoretical assessment, clinical operation skills, and case analysis ability scores of the interns in both groups were compared, and teaching satisfaction and improvement in autonomous learning ability were evaluated. Results The theoretical assessment (88.62±4.35), clinical operation skills (89.15±3.87), and case analysis ability (87.94±4.12) scores of the observation group were significantly higher than those of the control group (80.25±5.18), (81.36±4.52), and (79.88±4.69), respectively (all P＜0.05). The teaching satisfaction (94.12%) and improvement rate in autonomous learning ability (97.06%) in the observation group were significantly higher than those in the control group (75.76%), (72.73%), respectively (all P＜0.05). Conclusion The application of artificial intelligence-assisted case teaching in neurosurgery clinical internship teaching has achieved remarkable results. It can effectively enhance the comprehensive clinical abilities, autonomous learning abilities, and teaching satisfaction of interns. It is an efficient and feasible teaching mode, worthy of promotion and application.