Intro CBL as a knowledge delivery system The Case-Based Learning (CBL) has grown to be a common pedagogy in medical education as it focuses on the key problem-solving skills, synthetical understanding of the theoretical concepts and knowledge application. This work also found out that traditional lecture-based formats (LGF) as prevalent as they are, restrict students’ opportunity to apply knowledge in practice. The present research aims at assessing the impact of CBL in improving cognitive skills, problem solving ability and knowledge acquisition of final year MBBS students of Peshawar.Methodology:In the present study, we used a quantitative, cross-sectional questionnaire-based survey from January to June, 2024, across five medical schools. In the stratified random sampling technique, the last year 300 MBBS students were selected for the CBL and LGF groups, which were equally divided into the two groups. The students of the CBL group participated in the weekly seminars in form of case presentation, while the LGF group in the form of lecture presentations on the same cases. Evaluation of data collection included pre and posttest and a structured questionnaire that assessed the satisfaction and engagement. Repeated measures SPSS t-tests and chi-square tests were used to compare performance.Results:The findings highlighted better outcome on the CBL group by scoring higher a post-test (79.8% by 66.4 %, p > = 0.001), superior knowledge retention (86.7% by 73.2%, p > = 0.001), better performance on problem solving (88.5% by 69.7%, p > = 0.001) and critical thinking skills (80% by The CBL group recorded better satisfaction ratings than the control group 4.6/5 and 3.3/5 respectively on the Likert scale.Conclusion:The studies presented here provide clear evidence of CBL’s effectiveness in medical education from the viewpoint of cognitive and psychomotor competencies prerequisite to practice. Of course, there are still problems like faculty training, CBL structures and constraints and the like but if weighed against advantages, the end result is a clear nod in favor of CBL. If properly implemented with institutional support, CBL has the capability of transforming the whole system of medical education so that the students are well equipped to face heath demands in the societies.