Background <p>Digital Problem-Based Learning (DPBL) is becoming more frequently used to facilitate the development of knowledge and skills in medical education, yet student satisfaction and engagement with DPBL remain insufficiently understood.</p> Methods <p>This mixed-methods systematic review aimed to examine how medical students perceive and experience DPBL. We searched four databases (Feb 5–Jun 30, 2024) following JBI and PRISMA guidelines, yielding 3459 abstracts and 56 included studies. Studies published at any time and in any language were considered. Two researchers independently conducted screening, selection, quality assessment and analysis. A segregated approach was used to synthesize the data. This method included a thematic synthesis of the qualitative data and a narrative review/meta-analysis for quantitative data where appropriate. The findings of both syntheses were then integrated and validated by stakeholders.</p> Results <p>The mixed-methods synthesis demonstrated that both quantitative and qualitative findings complemented each other, offering a comprehensive understanding of medical students’ perceptions of DPBL. Overall, students had a positive evaluation of DPBL, despite some mixed perceptions. Quantitatively, the satisfaction rate was 78.51% (95% CI: 78.07% − 78.96%) across 20 studies. Qualitatively, students’ social perceptions varied, with some feeling isolated and others valued the focused learning environment. DPBL tasks provided ownership, autonomy, and flexibility. Technology was useful, engaging, and motivational, though feedback was occasionally lacking. Visual and auditory features were appreciated, but tactile realism was limited. The study findings were validated by 10 medical students.</p> Conclusions <p>Our findings suggest that DPBL design still struggles to reconcile technological innovation with the social principles of traditional PBL. A hybrid model may offer a practical way to bridge this gap.</p>