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Faculty development in effective lecture delivery is widely recognized as a critical strategy for improving student engagement in medical education. Peer feedback offers evaluative insights grounded in shared pedagogical and disciplinary expertise that complement, and extend beyond, student evaluations. This study aimed to pilot and evaluate a peer assessment and support initiative using the Peer Assessment of Medical Lecturing Instrument (PAMLI) to enhance lecturing practices among undergraduate basic science faculty and to explore faculty perceptions of the process. A mixed-methods study was conducted in the Department of Biological and Biomedical Sciences at Aga Khan University Medical College, Pakistan. Thirteen full-time basic science faculty members involved in undergraduate teaching were recruited through purposive sampling after ethical approval. Lectures were observed live by peer faculty using PAMLI, followed by structured formative feedback. Quantitative data included PAMLI scores and psychometric analyses (reliability, inter-rater agreement, factor analysis), while qualitative data were obtained through a post-intervention focus group discussion. PAMLI demonstrated high internal consistency (Cronbach’s alpha = 0.896) and excellent inter-rater reliability (ICC = 0.891). Most items showed positive, moderate correlations with overall performance, supporting construct validity. Factor analysis identified two meaningful components with moderate to strong factor loadings. Qualitative findings revealed mixed faculty experiences: many perceived peer feedback as constructive and reflective, while others reported demotivation and concerns regarding ratings, bias, and fairness. Participants emphasized the need for assessor preparation, alignment of feedback with session objectives, and a culture of trust. Peer assessment of lectures using a validated tool is an effective approach to improving teaching quality in medical education. Successful implementation requires institutional readiness, faculty buy-in, and sustainable recognition mechanisms to support peer observers and ensure constructive, unbiased feedback.