Objective To develop a blended learning model integrating three-dimensional visualization with scenario-based strategies and evaluate its effect on neuroanatomy learning outcomes among nursing undergraduate students. Methods Using a historical control design, this study designated 133 students from the class of 2024 at the School of Nursing, Peking Union Medical College as the traditional teaching group (TT), and 133 students from the class of 2025 as the blended learning group (BL). The BL group received four supplementary instructional strategies in addition to traditional teaching: three-dimensional imaging, virtual reality cloud-recorded sessions, anatomic model construction, and peer teaching. Upon course completion, both groups completed a theory examination of equivalent difficulty, with items drawn from a shared question bank administered under unified conditions, and anonymous questionnaires were administered to each group (TT group: voluntary completion, n=101; BL group: voluntary completion, n=133). Welch’s independent-samples t-test was used to analyze between-group differences. Results Results showed no statistically significant differences in baseline characteristics between the two groups (P>0.05). The BL group achieved higher theory examination scores than the TT group (24.0±3.09 vs 17.3±3.95, P<0.001). Course satisfaction (99.2%) and questionnaire response rate (100%) in the BL group were both higher than those in the TT group (88.1%; 75.9%). Between-group differences in self-assessed scores across all four core competency dimensions were statistically significant (P<0.001). Conclusion The blended learning model developed in this study integrates broadly applicable pedagogical innovations, including three-dimensional visualization, virtual reality, simulation training, and peer teaching, with nursing-relevant clinical case scenarios (embedded within the simulation training component, thereby linking generalizable teaching method  innovation with nursing competency development.