Team-based learning (TBL) combines independent out of class preparation with in class small group discussion. We adopted TBL in teaching first year medical gross anatomy. In this study, we evaluated student perceptions of TBL by using a survey that elicited perceptions of both pedagogy and mode of learning. Anatomy lectures were replaced with required preclass readings, self-assessment quizzes, small group discussions of assignments, and groups retaking the same quizzes for deeper learning. At the course conclusion, students were surveyed to assess their preference for TBL, their perceptions of TBL effectiveness, and their perceptions of successful interpersonal relationships within groups. Respondents (n = 317; 89% response) were asked to rate the extent that they agreed (-2 = strongly disagree; -1 = disagree; 0 = neutral; 1 = agree; and 2 = strongly agree). A principal components factor analysis with varimax rotation identified two 8-item factors: "perceptions of TBL" and "perceptions of teamwork". Internal consistency for each was high [Cronbach's alpha = 0.908 (preference for TBL); 0.884 (preference of teamwork)]. Results of one-way analysis of variance between Honors/High Pass/Pass/Fail students indicated that Honors (n = 73) tended to rate perceptions of TBL higher than Pass (n = 54) [mean difference = 2.92; 95% CI (0.05, 5.79)], and also higher than Fail (n = 11) [mean difference = 6.30; 95% CI (1.13, 11.47)]. However, each had overall positive ratings. No difference was noted between mean ratings of teamwork, which were also, overall, positive. We conclude that medical students view TBL favorably irrespective of their grades. (Contains 1 table and 2 figures.)