Objective To explore the effects of artificial intelligence (AI)-based outpatient triage and guidance on triage accuracy and outpatient satisfaction. Methods A total of 270 outpatients from November to December 2023 were selected as a control group using convenience sampling, and routine outpatient triage methods were adopted. Another 276 outpatients from November to December 2024 served as an intervention group, where an AI-based outpatient triage and guidance model was applied, including AI triage, AI-assisted appointment addition, and AI pre-consultation, with guidance provided by triage nurses throughout the process. Results The triage accuracy in the intervention group was significantly higher than that in the control group, and each item scores of outpatient satisfaction in the intervention group were significantly better than those in the control group (all P<0.05). Conclusion AI-based outpatient triage and guidance helps improve the accuracy of outpatient triage and enhance outpatient satisfaction.