Drastic changes are occurring in medical education around the world. Medicine and medical technologies are developing rapidly and expanding beyond the multidisciplinary area. The needs of medical care and medical education are different even from those of several years ago. In order to cope with these increasing social needs, the innovation of medical education in China has become an urgent and important problem. This study is an attempt to answer the question of how to develop medical education in China for the 21st century, based on a historical review of the development of medical education. This development might be divided into three periods: (1) before the Cultural Revolution; (2) the Cultural Revolution (1966-76); and (3) post-Cultural Revolution (1977-present) in modern China, and based on problem analysis of the curriculum, teaching methods, education evaluation, systems and policies and the balance between educational needs and supplies. We concentrate on the discussion of how to solve these problems, and have designed a new strategy for the further development of medical education in China. This discussion and newly developing strategy focuses on the main targets and priorities and adoption of suitable measures according to the conditions of the country. The purposes are to elevate the quality of medical education, to train qualified doctors to meet continuously increasing needs and to maintain the development of medical education for the 21st century in China.