In 1886 she established the Edinburgh School of Medicine for Women. Effectively a small extramural class, it was largely enabled by a small handful of pro-female male physicians linked to the University of Edinburgh giving extramural classes open to men and women (which the university could not prevent). The first students included Elsie Inglis, Grace Ross Cadell and her sister Georgina, but Jex-Blake's skill as a teacher did not match her role as a doctor. An acrimonious split emerged with her students culminating in an infamous court case in 1889, where Jex-Blake was successfully sued for damages. Thereafter the Cadell sisters pursued their studies with the more genial, though far younger, Elsie Inglis who had set up a rival school, the Edinburgh College of Medicine for Women. Jex-Blake's school came to an effective end in 1892 when the University of Edinburgh began taking female students. The Elsie Inglis College continued until 1916, when it merged with the School of Medicine of the Royal Colleges of Edinburgh at Surgeons' Hall.