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The Peking Union Medical College (PUMC) was founded in 1906 by American and British missionaries and funded by the Rockefeller Foundation. Designed by missionary architects, its buildings were completed in 1921, with many giving prominence to modified features of traditional Chinese architecture. During the construction process, western architects had to embrace an unfamiliar “Chinese style”, and Chinese craftsmen had to face new building technologies, materials and structures, such as reinforced concrete and metal trusses. This paper closely examines the construction history of PUMC buildings, with a special emphasis on their blueprints and worker’s organization, as well as building materials, structures and details. Through an analysis of the contradictions and compromises that were created by western architects and Chinese craftsmen, the paper demonstrates how that in a particular cultural and technical context, such an architectural style could be achieved, and in which ways the two different construction systems conflicted and interacted.