Background: Peer Assisted Learning (PAL) can create a cooperative learning environment, providing benefits to all students involved. While there is a large pool of research exploring PAL amongst medical students it is worth considering the use of PAL amongst students of different health disciplines. The objective of this study was to examine the perceptions of first year paramedic peer learners being taught by peer teachers over a three-year period. Methods: A cross-sectional study using the modified Clinical Teaching Preference Questionnaire (CTPQ) was administered to first year paramedic peer learners at a large Australian university during October 2011-2013. Results: Over a three year period, 361 peer learners participated in this study. The mean item-level result for each item was highest in the 2013 cohort compared to the earlier two years. Item 1 "Teaching is an important role for paramedics" reflected the highest mean score of the eleven items (4.46 in 2011; 4.52 in 2012; 4.60 in 2013) while item 2 "I feel freer to approach my instructor for help than I do my peers" reflected the lowest mean score (2011: 3.61; 2012: 2.99; 2013: 3.72). Conclusions: First year paramedic students over a three year period reported item-level results on the modified CTPQ which indicate that PAL is a valuable teaching method. This is consistent with previous research on PAL using students from other health disciplines. Results suggest peer learners believe teaching is an important role for paramedics, and communication between peer learners and teachers was slightly better compared with their tutors. Further mixed methodology work is required to explore other facets of paramedic PAL.