Background: Histology laboratory courses comprise the study of cell structures, tissues, and body organs, which are mainly examined using a microscope. Two types of examinations assess learning outcomes in these courses in Taiwan: the traditional, light microscope station (LMS) examination and the Microsoft PowerPoint (MS PPT) examination. Whether these examinations exhibit different influences on students’ grade performances remains to be examined. Aim: The aim is to compare the grade performance and opinion of students in a medical center for the LMS and MS PPT examinations. Methods: We compared the grade performances of students who completed LMS (3 cohorts) or MS PPT (2 cohorts) examinations retrospectively and conducted a survey to investigate the students’ learning attitude between these two types of examinations. Results: Grade performances in the MS PPT group were not significantly higher than those in the LMS group. The average scores of students who failed the LMS examination were significantly lower than those of students who failed the MS PPT examination. Questionnaire survey results showed that the MS PPT examination was easier for students and that they may spend less time studying for it. The LMS examination positively influenced learning attitudes among students with a rather low self-demand. Conclusion: Examination type may affect learning attitude, especially among students with a rather low self-demand. The MS PPT examination seems to be easier for students and was connected to remarks about less study time in the histology laboratory course, and for students with low self-demands, the traditional LMS examination may be a better option. We believe that with the advance of digital whole histology slide imaging, there is an opportunity to revolutionize both learning and evaluating for all medical school students.