Case-based learning (CBL) has been in practice throughout the world for several decades now. Our institute adopted it some four years back when we shifted toward a modular system of teaching. It is the main technique being used for conducting small group discussions. We decided to introduce a new technique called the gamification technique for conducting small group discussions. There was a need to determine the effectiveness of this new method, as well as to assess factors for its preference so that it could be modified to increase its efficacy. The aim of this research was to quantitatively and qualitatively assess the effectiveness of said gamification teaching technique by comparison with the traditional CBL technique. This was a mixed-method, randomized controlled trial. It was conducted at Khyber Medical College on first-year medical students from June to October 2021. Group-based teaching involving both CBL and the gamification approach was used in this study in a crossover manner. Addressing the ethical concerns, and after informed consent pre-testing and post-testing were done to quantify the performance, an open-ended survey was disseminated after the sessions to check the perceptions of the students. The study recorded (quantitatively) that the post-testing mean score of the gamification teaching technique was 3.41 ± 0.982. For CBL, the mean was 3.55 ± 1.055. This showed a recording of an insignificant difference with a p-value of 0.608. In qualitative analysis, about 12 (80%) students preferred the gamification technique. Their perception was that it instilled competitiveness and increased the involvement of students in class. Gamification also raised their motivation level. This research further revealed that the CBL approach had the advantage of quick learning via the facilitator presentation. Due to the handouts, it was easy to follow. One of the negative points of CBL was that the participants found it a boring and monotonous way of learning. The chief drawback of gamification was that the students were unsure about the accuracy of the information they initially prepared, as it was not being directed by the facilitator. The study concluded an insignificant quantitative difference between the two techniques. On the qualitative end, however, the students preferred gamification.