Background <p>Basic medical pathology teaching suffers from fragmented knowledge and insufficient personalized learning, which impairs students’ systematic knowledge construction and learning efficiency. This study aimed to apply an AI and knowledge graph integrated teaching model to address these challenges and provide references for basic medical education reform.</p> Methods <p>An 18-week randomized controlled trial was conducted on 360 nursing students (180 each in experimental/control groups). The control group used traditional teaching, while the experimental group adopted the “AI + knowledge graph” integrated model with AI-assisted learning and knowledge graph reviews. SPSS was used for quantitative and qualitative data analysis.</p> Results <p>The experimental group showed significantly better outcomes: final score (84.2 ± 6.9 vs. 74.1 ± 7.6), after adjusting for class-level clustering using a two-level mixed-effects model, adjusted mean difference = 8.2, 95% CI: 4.7–11.7, <i>P</i> = 0.012, Cohen’s d = 1.13 (95% CI not computed), indicating a large effect size. knowledge mastery rate (90.3% vs.75.8%), clinical case analysis score (28.5±3.2 vs. 21.3±4.1, <i>P</i>&lt;0.001). It also reduced ineffective learning time.</p> Conclusion <p>This integrated model effectively promotes structured knowledge construction and learning efficiency, realizing the synergistic effect of AI and knowledge graph. It provides a replicable and practical reference for the digital and intelligent reform of basic medical education courses.</p>