Purpose: This study is a quasi-experimental study to investigate the effect of case-based learning (CBL) on critical thinking disposition, communication ability, problem solving ability and self-directed learning ability of nursing students in a pathophysiology course. Methods: The development of 3 CBL scenarios of pathophysiology were conducted by nursing faculties & clinical nurses before CBL began. Among the sophomore nursing students who were taking a pathophysiology course, the intervention group (n=43) was the nursing students who hope to participate in an extra-CBL program with usual pathophysiology lessons and the control group (n=36) was the nursing students who wanted to receive the usual pathophysiology lessons. The intervention group received additional CBL using 3 different scenarios for 1 hour per week during 4 weeks from May to June, 2016. Data were analyzed by a chi-square test, t-test and ANCOVA using SPSS WIN 18.0 Results: The mean score of critical thinking disposition (F=11.60, p=.001), communication ability (F=4.24, p=.043), and self-directed learning ability (F=4.75, p=.032) were significantly higher in intervention group than those in control group. But there was no significant difference between the two groups in problem solving ability (F=1.59, p=.211). Conclusions: The application of a CBL program during a pathophysiology course was effective in improving the critical thinking disposition, and the self-directed learning ability of sophomore nursing students.