Objective To explore the effect of medical image control system in the standardized training for thoracic surgery residents. Methods From March 2019 to March 2022, 100 residents who were undergoing standardized training in department of thoracic surgery, Harbin Medical University Cancer Hospital were selected as study subjects. They were randomly divided into study group and control group according to the random number table method. Fifty residents in the study group were taught with medical image control system, while fifty residents in the control group were taught with traditional method. The score of graduation examination, clinical skill assessment and evaluation feedback were compared between the two groups. T test and χ² test were used to compare the differences between the two groups. Results The theory and image reading graduation examination scores in the study group were higher than those in the control group [(44.4±3.4) vs. (38.8±3.9),(41.3±2.7) vs.(34.3±2.3), all P<0.05]. The scores of the residents in the study group were higher than those in the control group in the accuracy of image diagnosis [(84.4±7.4) vs. (62.1±8.5)], the analysis ability of image differential diagnosis [(91.4±4.0) vs. (74.5±7.1)], and the ability of clinical operation [(82.7±6.3) vs. (75.2±6.7)](all P<0.05). The teacher's evaluation of the image reading ability of the residents in the study group was higher than that of the residents in the control group [(8.3±0.6) vs.(7.4±1.1),t=5.50, P=0.008]. Conclusions The application of medical image control system in the standardized training for thoracic surgery residents can improve the residents' learning effect, enhance their clinical theory and practical ability, and increase their comprehensive quality.