Objective To explore the training effect and significance of stepped microvascular anastomosis training program. Methods A total of 72 neurosurgeons from hospitals at all levels who had not been trained in vascular anastomosis operation were selected and divided into control group and treatment group, 36 in each group. A total of 288 male Sprague-Dawley rats were randomly selected. To the treatment group, the training was carried out in three stages, including end-to-end common carotid artery anastomosis, end-to-side common carotid artery anastomosis, and end-to-side femoral vein-femoral artery anastomosis under the operating microscope. To the control group, the training of end-to-side femoral arterio-femoral vein anastomosis was performed at all three stages. Each of the two groups completed 1 rat in each stage. After the training, both groups underwent microscopic assessment of the end-to-end anastomosis of the common carotid artery. Time of vascular anastomosis, the vascular patency after operation, the patency of the vascular 24 hours after surgery and the postoperative survival of rats were measured. And then analysis and comparison. Results In the treatment group, 29 rats effectively completed the experiment. The average anastomosion time was (45.2±4.79) min. The immediate vascular patency rate was 86.2% (25/29) and the 24h postoperative vascular patency rate was 82.8% (24/29). The survival rate was 86.2% (25/29). In the control group, 30 rats effectively completed the experiment. The average anastomotation time was (42.6±4.26) min. The immediate vascular patency rate was 63.3% (19/30) and the 24h postoperative vascular patency rate was 56.7% (17/30). The survival rate was 60.0% (18/30). Compared with the control group, the mean time of vascular anastomosis, immediate and 24h patency rate and postoperative survival rate were significantly different in the treatment group (P<0.05). Compared with the first and second stages, the mean time of vascular anastomosis, immediate and 24 h patency rate in the third stage were significantly different(P<0.05). Conclusion Through the stepwise training method, from simple to complex, in line with the actual requirements of clinical work, can enable trainees to gradually master a variety of vascular anastomosis techniques, effectively improve the technical level of students, make them closer to the clinical level. In order to make the trainees truly qualified for clinical work, long-term training is still needed.