Background: Performance-based assessment (PBA) is an integral component of health professional education as it determines students' readiness for independent practice. Stakeholder input can provide valuable insight regarding its challenges, facilitators, and impact on student learning, which may further its evolution. Currently, evidence of stakeholder opinion is limited. Thus, we aimed to explore physiotherapy students' perceptions of performance-based assessment in their capacity as its central stakeholders.Methods: A qualitative interpretive constructivist approach was employed using focus group interviews for data collection. Six focus groups were completed (n=33). Inductive thematic analysis was used to explore the data.Results: Two themes were identified. The first outlined perceived inconsistencies within the process, and how these impacted on student learning. The second described how students used their experiential knowledge to identify strategies to manage these challenges thus identifying key areas for improvement.Conclusion: Inconsistencies outlined within the current physiotherapy performance-based assessment process encourage an emphasis on grades rather than on learning. It is timely that the physiotherapy academic and clinical communities consider these findings alongside evidence from other health professions to improve assessment procedures and assure public confidence and patient safety.