Purpose/Significance To discuss the current cognitive status of medical students on preprints and strategies for improving their literacy, and to provide references for the literacy education of medical students on preprints. Method/Process A questionnaire survey is conducted among students at Capital Medical University to assess their understanding of preprints, use concerns, as well as educational demands. Result/Conclusion Medical students generally have insufficient understanding of the concept and resources of preprints, have certain concerns about using preprint resources and platforms to publish papers, and have educational needs to enhance cognition. Strategies for improving literacy are proposed, including strengthening the popularization of preprint knowledge, customizing educational content for different educational levels and majors, constructing a comprehensive preprint literacy education system, improving the evaluation and feedback mechanism, etc.