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Teachers' perceptions are critical for developing blended learning (BL) and the quality of higher education. Understanding the current phenomenon of teachers' perceptions, challenges, and needs in the BL mode is essential. The study is an exploratory case study in a medical university in Mainland China. Semi-structural individual interviews are used to advance understanding of teachers' experiences and perceptions toward implementing BL practices. Findings suggest that teachers and students could benefit from BL by 1) extending time and space for teaching and learning. 2) increasing the diversity of teaching activities and student-teacher interactions. 3) gaining positive attitudes from students. The challenges of BL are significant from teachers' different beliefs, pedagogical literacy, and unclear guidelines.