ObjectiveTo systematically evaluate the types of interventions, the application of outcome measures, and the reporting quality of randomized controlled trials (RCTs) in medical education, and to provide evidence-based support for improving study design and optimizing evaluation frameworks in this field. MethodsPubMed, Embase, CBM, CNKI, and WanFang Data databases were systematically searched from inception to April 2025. A total of 340 medical education RCTs were included through stepwise random sampling and screening. Descriptive statistics were used to summarize publication characteristics, participant types, intervention classifications, and distributions of outcome measures. Regression analysis was conducted to identify factors associated with reporting quality. ResultsRCTs of medical education were included, with the majority originating from China (n=284). Participants were predominantly undergraduate clinical medical students, and sample sizes were mainly small to moderate (20-60 participants). Cognitive-oriented interventions accounted for the largest proportion (76.03%), and control group designs were highly homogeneous. A total of 843 outcome measures were identified, primarily focusing on short-term outcomes such as theoretical knowledge and clinical skills, whereas long-term outcomes (e.g., behavioral changes and patient-related outcomes) were markedly underrepresented. Overall reporting quality was suboptimal, with inadequate implementation of blinding and allocation concealment. Multivariable regression analysis indicated that explicit specification of primary outcomes, study region, and intervention type were significant determinants of reporting quality. ConclusionSignificant gaps remain in intervention design, outcome selection, and methodological reporting in medical education RCTs, particularly in the development of long-term outcome measures and adherence to key methodological standards. This study systematically synthesizes existing evidence and identifies key factors influencing reporting quality, providing empirical support for improving RCT design, standardizing outcome measure systems, and enhancing methodological rigor in medical education research. The findings also offer important implications for educational practice and policy-making.