Medical education has evolved significantly, integrating innovative techniques to enhance student learning. One such approach, gamification, applies game-based elements to educational settings to increase engagement and retention. This study evaluates the impact of gamification on medical students' knowledge retention and engagement levels using a randomized controlled trial design. A total of 240 medical students were randomly assigned to two groups: the gamification group (n=120), which used interactive, game-based learning tools, and the control group (n=120), which received traditional didactic lectures. The sample size was calculated using Epi software, ensuring a statistical power of 80% with a confidence level of 95%. Inclusion criteria encompassed enrolled medical students in their second year, whereas students with prior exposure to gamified learning modules or those unwilling to provide verbal consent were excluded. Retention was assessed through pre- and post-intervention tests, while engagement was measured using validated Likert-scale surveys. The results demonstrated statistically significant improvements in the gamification group, with a mean post-test score of 85.3±8.1 compared to 76.2±7.4 in the control group (p<0.001). Engagement scores were also higher in the gamified cohort (4.5±0.6 vs. 3.7±0.8, p<0.001). These findings suggest that gamification significantly enhances knowledge retention and engagement among medical students. This study highlights the potential of gamification as a transformative approach in medical education, bridging gaps in traditional methodologies. Future research should explore its long-term effects and applicability across diverse medical curricula.