Background: Chalk board teaching as a medium of instruction in classroom is one of the most commonly used methods in lectures. In the recent past there is increased use of power point presentations which is now one of the most popular methods of delivering the lectures using electronic devices. In medical colleges chalk board teaching and PPT–based lectures are being used extensively and there is also a debate wherein the teaching faculty are divided in their opinion regarding the superiority of traditional chalk and talk method and PPT-based lectures. Objectives: To estimate the preferences of first year medical students between traditional chalk and talk lectures and PPT-based lectures. To assess the student perceptions about traditional chalk and talk lectures and PPT-based lectures. Methodology: A cross sectional study was carried out among 130 first year medical students of 2015-16 batches belonging to Sri Siddhartha Medical College Tumkur, Karnataka. A self structured questionnaire was administered to the study population and preferences of the students were estimated in percentage. Results: 66.15% (86) of the student preferred the traditional chalk and talk method over PPT-based lectures. 8.46% (11) of the students preferred PPT-based lectures as a mode of teaching method citing that this technique offers them better quality of diagrams, pictures and sequence of images. 25.38% (33) of students preferred the use of both the methods in the lecture wherein they feel that usage of black board to explain the key concept along with PPT-based lectures as a better method of teaching.