Background: The use of virtual reality (VR) training in high-stakes fields, including medicine, aviation, and the military, prepares individuals for complex scenarios in a safe and controlled setting. VR aligns with dual-code theory, enhancing learning through visual and kinesthetic engagement. This review investigates the application and effectiveness of VR in preclinical medical education, particularly its role in supporting LCME mandates on self-directed learning and competency-based education. This systematic review synthesizes research published between 2005 and 2023 to evaluate the significance and effectiveness of VR technology in preclinical medical education, an area that remains underexplored compared to clinical training. Method: A systematic review following the preferred reporting items for systematic reviews and meta analyses (PRISMA) guidelines was conducted in July 2023 using the PubMed and Scopus databases and search terms such as "medical education", "preclinical" and "VR or virtual reality". All relevant studies were screened and collated by two independent reviewers. Result: Of the fourteen studies, thirteen found VR to enhance engagement, interactivity, and group work. A statistically significant improvement in student performance and self-efficacy was found in over half of the studies. Positive feedback was prevalent, with VR seen as effective and suitable for augmenting traditional teaching, not replacing it. Concerns included high costs, cybersickness, and usability challenges. VR was frequently recommended for clinical skills, anatomy, and surgery training, providing a safe, immersive environment for students. Conclusion: VR technology offers a dynamic and immersive learning experience that enhances student engagement, procedural confidence, and spatial visualization. Our review suggests that VR aligns well with modern medical education standards, including LCME's emphasis on self-directed learning and competency-based training. It supports independent practice and clinical skills development, particularly in OSCE preparation, anatomy visualization, and surgical training, by offering safe, interactive environments for students to learn from mistakes without patient risk. While VR will not replace lectures, cadaveric dissection, or standardized patients, it serves as a powerful complementary tool that can enhance traditional teaching methods and may, in certain contexts, surpass textbooks in utility. Future advancements aimed at reducing costs, improving usability, and minimizing cybersickness could further broaden VR's role in preclinical medical education.