Objective To explore the effect of heterogeneous group cooperative learning in flipped classroom teaching for undergraduate nursing students. Methods Four classes enrolled in 2017 were selected through convenience sampling method. The classes were randomly divided into a control group of 58 students, who received traditional teaching method in the course of Health Assessment, and an intervention group of 59 students, who received the teaching mode of cooperative learning combined with flipped classroom according to the heterogeneity of examination grades for the course of fundamentals in nursing.At completion of the course, the teaching results were compared between the 2 groups. Results There were no statistically significant differences between the two groups in written and skill exams （P＞0.05 for both）.There were statistically significant differences in the total score of autonomous learning ability, and the dimensional scores of planning and implementation, and self-management between the two groups after intervention （P＜0.01 for all）. Conclusion Heterogeneous group cooperative learning combined with flipped classroom teaching can improve nursing students′ autonomous learning ability.