BACKGROUND: The flipped classroom (FC) approach has demonstrated efficacy in enhancing the learning process, including within higher education contexts such as medical education. Recently, FC has emerged as potential alternative to traditional teaching models across various disciplines, particularly due to its more engaging nature. However, there is limited data available regarding its impact on student performance, particularly in the context of long-term knowledge retention in pharmacology. In this study, our objective was to assess the short- and long-term impact of FC on student performance in Hungarian pharmacology teaching at medical faculty in Semmelweis University (Budapest, Hungary). METHODS AND RESULTS: 161 medical students and 10 teachers were involved in this study. We flipped four seminars, then we assessed the academic performance by using multiple choice tests immediately and two weeks after the flipped class. A follow-up assessment was conducted six months after the initial two FC sessions. Our findings indicated that the FC approach enhanced both short- and long-term knowledge retention across most topics. Notably, this long-term improvement was evident even six months after the original seminars on specific subjects. However, despite these topic-specific benefits, the overall performance, including exam grades, did not show significant improvement when compared to the conventional teaching approach. Additionally, we assessed student and teacher perceptions using two questionnaires immediately after practice and at the end of the year. According to the questionnaire responses, students perceived positively the FC approach, emphasizing its interactive and thought-provoking aspects. However, they identified the time-consuming nature of preparation as a significant concern. Teachers also viewed the FC approach favorably, particularly appreciating its interactivity and potential for greater effectiveness. Interestingly, more experienced teachers were less receptive to the FC method, and their perceptions of it were less favorable compared to those of their younger colleagues. CONCLUSIONS: The flipped classroom approach presents a viable strategy for teaching pharmacology, with the potential to enhance student performance and engagement. However, student occupation and faculty resistance may pose significant challenges to the implementation of such alternative teaching methods.