Purpose/Significance To investigate the relationship between the online learning behaviors and engagement of medical students in the context of digital transformation of education, and to provide references for improving the effectiveness of online learning. Method/Process A sampling survey is conducted on the teaching objects of the online course “medical literature retrieval and research utilization” at Chongqing Medical University. Descriptive statistics, difference analysis, K-means clustering, correlation analysis and binary logistic regression analysis are employed to analyze the characteristics of online learning behaviors, learning engagement and its influencing factors, as well as the relationship between online learning behaviors and engagement. Result/Conclusion There are statistically significant differences in the behavioral characteristics and engagement of medical students in online learning among different majors and genders. High behavioral cluster learners exhibit higher engagement in online learning. Attention should be paid to the impact of key factors such as gender, major, and the cluster of learners on online learning.