Objective To investigate the effectiveness and significance of the stepped training program of microvascular anastomosis.Methods A total of 72 neurosurgeons who came from the hospitals at different levels and did not undergo the training of vascular anastomosis were selected and divided into control group and experimental group， with 36 neurosurgeons in each group， and a total of 288 healthy male Sprague-Dawley rats were selected. The neurosurgeons in the experimental group received the training in three stages， i.e.， 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， while those in the control group received the conventional training of end-to-side femoral artery-vein anastomosis in all three stages. Each individual completed the surgery for one rat in each stage. After the training， the neurosurgeons in both groups underwent microscopic assessment of end-to-end common carotid artery anastomosis， and the two groups were examined and compared in terms of the time of vascular anastomosis （from the placement of the clip to the release of the clip）， vascular patency rate immediately after surgery， vascular patency rate at 24 hours after surgery， and the postoperative survival rate of rats.Results In the experimental group， the surgery was effectively completed for 29 rats， with a mean anastomosis time of 45.2±4.79 minutes， a vascular patency rate of 86.2% （25/29） immediately after surgery and 82.8% （24/29） at 24 hours after surgery， and a postoperative survival rate of 86.2% （25/29）. In the control group， the surgery was effectively completed for 30 rats， with a mean anastomosis time of 42.6±4.26 minutes， a vascular patency rate of 63.3% （19/30） immediately after surgery and 56.7% （17/30） at 24 hours after surgery， and a postoperative survival rate of 60.0% （18/30）. There were significant differences between the two groups in the mean time of vascular anastomosis， vascular patency rate immediately after surgery and at 24 hours after surgery， and postoperative survival rate （all P <0.05）.Conclusion Literature review shows that existing anastomosis training programs fail to achieve satisfactory training results. The stepped training program of microvascular anastomosis， from simple to complex， can better meet the actual requirements of clinical work， helping trainees to gradually master various vascular anastomosis techniques and effectively improving their technical abilities. Long-term training is still needed to help trainees become truly qualified for clinical work.