The history of Chinese and foreign music is a core theoretical course in the music education system of higher education institutions, serving multiple functions including historical organization, aesthetic education, cultural dissemination, and value shaping. Against the backdrop of strengthening cultural confidence and building a culturally strong nation, traditional teaching of Chinese and foreign music history has encountered structural issues such as overemphasis on the West at the expense of China, prioritizing knowledge over values, focusing on theory over culture, and valuing inheritance over innovation. These shortcomings hinder its ability to fulfill the mission of promoting China’s excellent traditional music culture and fostering cultural confidence among young students. This paper adopts cultural confidence as a theoretical perspective to analyze the current practical challenges in Chinese and foreign music history teaching, elucidates the intrinsic logical relationship between cultural confidence and music history education, and proposes teaching reform pathways from six dimensions: teaching philosophy, curriculum structure, teaching content, teaching methods, evaluation systems, and value guidance. It explores how music history courses can serve as a vehicle to achieve an organic integration of knowledge transmission, skill development, and value leadership, providing theoretical support and practical solutions for higher education institutions to implement the fundamental task of moral education and enhance young people’s cultural confidence.