The anatomical structure of the nervous system is complex, the proportion of microscopic and fine manipulations of neurosurgery is high, and there are many acute and critical illnesses, often involving multi-system lesions and multi-disciplinary fields. Thus, the clinical learning of neurosurgery is difficult. However,the eight-year program students in the clinical neurosurgery have insufficient study time,this puts forward higher requirements for clinical teaching and learning. This paper analyzes the problems existing in the current clinical practice of neurosurgery in domestic medical colleges and the causes of the problems by reviewing the literature combined with discussing teaching practice of Peking Union Medical College Hospital, and probes into suggestions for the clinical teaching reform of neurosurgery for eight-year program students. It is recommended to use the self-learning platform to enable medical students to understand neurosurgery in advance and establish clear learning goals; conduct scientific research guidance to guide students to correctly handle the relationship between scientific research and clinical learning; adopt medical student teaching assistant and segmented chief surgeon system to improve the basic operation skills of medical students, and lay a good foundation for the eight-year students to enter the neurosurgery to engage in clinical work after graduation.