Abstract: Objective To investigate the effect of systematic pre-examination surgical skills training (hereinafter referred to as pre-examination training) on the pass rate of skills examinations in standardized surgical residency training (hereinafter referred to as residency training). Methods A retrospective analysis was conducted. A total of 395 residents who participated in the standardized residency training program at the Surgical Training Base of Beijing Friendship Hospital, Capital Medical University from 2016 to 2025 were divided into a pre-examination training group (n=144) and a non-pre-examination training group (n=251). Their final skills examination scores were collected, and data processing was performed using SPSS 22.0 statistical software. The independent effect of pre-examination training on the examination pass rate was analyzed, and the effects of factors such as gender, student source type, and educational background on training effectiveness were explored. Results  Among the 395 participants, 144 received systematic pre-examination surgical skills training, with a pass rate of 95.83%; while 251 did not receive training, with a pass rate of 87.65%. Multivariate logistic regression analysis showed that participation in systematic pre-examination surgical skills training was a protective factor for improving the pass rate (OR=3.165, 95% CI:1.363-8.646, P=0.007). Gender and student source type were not independently associated with examination passing, and showed weak correlation with the training effect. The pass rate of the pre-examination training group was consistently higher than that of the corresponding non-training subgroups, and training effectively offset the inherent pass rate differences among different sources and genders. Conclusion Systematic pre-examination surgical skills training can significantly improve the pass rate of skill examinations among surgical residents and serves as an effective educational intervention to optimize the quality of surgical residency training.