Based on the OBE (Outcome-Based Education) theory and oriented towards serving grassroots medical needs, this study constructed an online and offline blended teaching model for the Histology and Embryology course tailored for rural-oritented medical students, and established a teaching reform system featuring “grassroots orientation, diversified design, and comprehensive evaluation”. The results indicated that the experimental group scored significantly higher than the control group at the experimental test, final exam, and overall exam (P < 0.05). Questionnaire results indicated that the experimental group was highly satisfied with the teaching reform. This practice shows that this teaching reform not only significantly improves students’ academic performance but also strengthens their sense of professional identity with grassroots work and enhances their competence in grassroots service, offering useful theoretical and practical reference for training general practitioners for grassroots healthcare.