Objective <p>Near-Peer-Assisted Teaching (NPAT) is an innovative instructional approach in which senior students facilitate learning among their junior peers in a structured and supportive environment. This study evaluated the effectiveness of NPAT in improving basic clinical skills among undergraduate medical students at a rural tertiary care teaching institution.</p> Methods <p>A study with a quasi-experimental design was conducted at a rural tertiary care teaching institution in Maharashtra, India, wherein Phase III MBBS students were divided into an intervention group receiving NPAT and a control group undergoing conventional faculty-led teaching. Trained senior students conducted sessions on temperature, pulse, respiratory rate, and blood pressure measurement. Clinical competence was assessed using Objective Structured Clinical Examination (OSCE) scores.</p> Results <p>Out of 80 Phase III, Part 1 MBBS students included in the study, the ones exposed to NPAT (<i>n</i> = 40) demonstrated significantly higher mean OSCE scores and greater attainment of expected competency levels across all skills: temperature [8.97 (0.99) vs. 5.20 (2.10)], pulse rate [7.07 (1.02) vs. 5.12 (1.74)], respiratory rate [6.45 (0.67) vs. 4.49 (1.58)], and blood pressure measurement [13.85 (1.20) vs. 8.02 (2.61)]; <i>P</i> &lt; 0.001 for all comparisons with controls (<i>n</i> = 40). Attendance and engagement were also better in the NPAT group as compared to control group, respectively (88% vs. 57.5%).</p> Conclusion <p>Incorporating NPAT into competency-based medical education may enhance skill acquisition and learner participation.</p>