Introduction:Peer-assisted teaching and learning (PTL) is a learner-centered approach increasingly adopted in medical universities globally, employing active learning strategies to engage students. This study explores student perceptions of PTL in the context of group-led seminars, fishbowls, and interactive classroom activities, with a focus on conceptual topics related to various types of anemia. Objective:The primary objectives of this study were to investigate student perceptions of PTL methods, specifically group-led seminars, fishbowls, and interactive activities, and to compare their acceptability and efficacy in understanding various types of anemia. Methods: Second-year medical students participated in ten consecutive PTL sessions, incorporating group-led modified seminars, fishbowls, and interactive activities like street plays, prop sessions, and quiz sessions. The aim was to enhance their comprehension of the clinical features and etio-pathogenesis of different types of anemia. Focus group discussions involving 14 students and one facilitator each were conducted to delve into the factors influencing learning. Qualitative thematic analysis was performed on audio recording transcripts by the authors. Results:The thematic analysis revealed several key aspects that influenced the effectiveness of PTL. These aspects fell under the categories of teacher, student, and organization. Noteworthy findings included the significance of peer teacher motivation, student interest and collaboration, contact time between students and facilitators, preparation time, alignment with other curricular activities, group size and composition, topic suitability for specific activities, and the availability of preparatory materials. These sub-aspects played pivotal roles in shaping the learning experience. Conclusion: The study underscores the importance of various factors in the success of PTL. Effective PTL requires the dedicated involvement of peer teachers, student receptiveness, and sufficient contact time. Adequate preparation, alignment with the curriculum, and course coherence are prerequisites for optimal PTL outcomes. This research offers valuable insights into the dynamics of PTL in medical education, highlighting the need for careful planning and consideration of these factors to enhance the learning experience.