An automatic vending machine includes a cabinet, a plurality of item columns, a pickup port and a delivery apparatus, and the delivery apparatus includes a hopper and a hopper drive mechanism. An item dispensing method of the automatic vending machine includes: determining, according to items to be purchased, all of item combination manners having a lowest number of item dispensing operations as candidate item combination manners; determining all of pickup manners for picking up items in each of the candidate item combination manners; determining all of item dispensing paths in one-to-one correspondence to all of pickup manners of all of the candidate item combination manners; and selecting, from all of the item dispensing paths, an item dispensing path having a highest efficiency as a target item dispensing path, and controlling, based on the target item dispensing path, the hopper to dispense items.