As one of the indicators reflecting student well-being in medical education practice, student satisfaction is no doubt an important topic. Instead of exploring student satisfaction from the perspectives of education quality and organizational factors, this study focused on student engagement to explore the impact of it on student satisfaction with medical education in China. Student engagement refers to students' actions, efforts and persistence, indicating both time and energy students invested in educationally purposeful activities, especially academic activities. The data used in this study came from the first national survey of clinical undergraduates--the China Medical Student Survey--in which 10,062 clinical medical undergraduates in 33 medical schools participated. We developed a model of medical student engagement and satisfaction and utilized descriptive statistics, ordered logit regression, and path analysis to describe the relationship between medical student engagement and satisfaction. In this study, student engagement was categorized into behavioral, emotional and cognitive dimensions. The findings showed that medical student satisfaction was relatively low and was significantly affected by student satisfaction, especially the behavioral engagement in clinical rotations and professional identity of emotional engagement. These findings could put a supplementary perspective on improving student satisfaction through student engagement, and offer notable implications for future research and practice.