Summary Background As medical schools strive to improve the learning environment, it is important to understand medical students’ perceptions of mistreatment. The purpose of this study was to explore student interpretations of previously reported mistreatment incidents to better understand how they conceptualise the interactions. Methods Medical students were presented with case scenarios of previously reported instances of mistreatment and asked to indicate their agreement as to whether the scenarios demonstrated mistreatment, using a five‐point Likert scale (1, strongly disagree; 5, strongly agree). It is important to understand medical student’s perceptions of mistreatment Results One hundred and twenty‐seven third‐year medical students gave feedback on 21 mistreatment cases. There was variability in the categorisation of the scenarios as mistreatment. The highest degree of consensus (96% agreement) was for a scenario in which a resident claimed a student made statements about a patient’s status that the student did not make. There was also relative consensus on three additional scenarios: (1) a patient making disparaging remarks about a student’s role in health care in relation to the student’s ethnicity (88% agreement); (2) a resident asking a student to run personal errands (86% agreement); and (3) a nurse calling a student an expletive in front of others (77% agreement). For the majority of the cases, there was no consensus amongst students as to whether mistreatment had occurred. Students self‐identifying as minorities and students who had previously reported mistreatment were more likely to perceive mistreatment in the scenarios. Conclusions There is remarkable variability, and in many cases a lack of agreement, in medical student perceptions of mistreatment. This inconsistency needs to be considered in order to effectively address and mitigate the issue.