The purpose of this qualitative, single-site case study was to describe how physical therapist students perceive and approach learning during case-based instruction. Eight subjects, who were senior physical therapist students at an urban university with over 19,000 students, were selected using a purposeful sampling technique. Data were collected through a series of one-on-one interviews. Students were interviewed three times during a 10-week course entitled “Clinical Integration,” which used a case-based instructional methodology. From these interviews, six major themes were identified: (1) value of cases to evoke learning as an outcome, (2) integration of knowledge and stimulation of thinking, (3) motivational aspects of cases, (4) stress, (5) organizational strategies, and (6) group dynamics and interaction skills. Students indicated that cases served as a stimulus for clinical thinking and promoting an indepth thought process. Cases were motivating because they were complex, challenging, realistic, and required the integration of classroom material versus factual recall. Organizational strategies included problem identification and generation of ideas for approaching the cases using references, brainstorming, and outside sources. Collaboration fostered a sharing of ideas and clinical knowledge but also caused stress due to conflicting group goals. An understanding of students' experiences with casebased instruction has implications for the design of instruction and the classroom context in physical therapy education. This information can be used to generate, evaluate, and improve the curriculum by encouraging and promoting the learning strategies used by successful students and by identifying the problem areas experienced.