Background: Paper-based-lecture handouts were developed as teaching aids and study guides for learning and revision before examination, since it makes learning more easy and helps students save time and focus their study on the subjects. Handouts impact were: understanding is facilitated, exam anxiety is reduced, academic performance is enhanced, and achieving better results. Objectives: Aim of the study was to determine perception of medical students on paper-based-lecture handouts as learning tool and how this tool used by them. Methods: A cross-sectional study was conducted at the Medical College of Alkindy-University of Baghdad, A 20-item questionnaire regarding perception towards paper-based lecture handouts was distributed to 174 first year medical students. The answers were analyzed using SPSS v17. Results: Majority (97.1%) agree or strongly agree that the paper handouts were useful, (93.7%) of them agree or strongly agree that the paper handouts make learning more easy, (77.6%) of them agree or strongly agree that the paper handouts help them to achieve better results, (94.8%) of them agree or strongly agree that the paper handouts considered as a guide before an examination, (94.3%) of them agree or strongly agree with receiving complete paper handouts. Conclusion: This study showed that first year medical students, expectations were positive towards complete paper-based-lecture handouts and prefer to be distributed before lecture, regarded it as a useful important and essential teaching tool.