Objective To explore the application of case-oriented objective structured clinical examination (OSCE) in the training and assessment of stroke emergency nurses.Methods From Jun. 2018 to Jun. 2019, 71 stroke emergency nurses were enrolled in this study. The rescue ability of stroke emergency nurses in the stroke green channel was evaluated by OSCE based on practical cases, stroke emergency process and occupation ability requirements in the emergency rooms. Six stations were set up for the evaluation, including preliminary assessment of acute ischemic stroke (AIS), nursing operation, patient transfer from emergency inquiries to computed tomography (CT) room, cooperation between nurses and imaging technicians before and after CT and multi-mode CT examination, use of intravenous thrombolytic drugs, and disease observation and education in the process of intravenous thrombolysis. The score rate in each station, coefficient of difficulty and degree of distinction were calculated after the examination, and the student feedback on the examination was assessed by a questionnaire.Results The examination score of 71 stroke emergency nurses was 78.6-95.8, with an average of 82.9±3.2. The coefficient of difficulty was 0.17 and the degree of distinction was 0.36. The average score rate of the 6 stations was 86.1%, and the second station had the highest score rate (92.2%) and the fifth station had the lowest score rate (74.3%). Most examinees believed that this examination mode was in line with clinical practice (97.2%, 69/71), could reflect the clinical thinking ability (95.8%, 68/71) and the comprehensive ability (95.8%, 68/71) in AIS first aid, and was worthy of clinical promotion (98.6%, 70/71).Conclusion The case-oriented OSCE mode can objectively reflect the comprehensive ability of stroke emergency nurses in AIS first aid, and has been recognized by examinees.