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Introduction: Team based learning (TBL) is student centered learning designed to allocate student groups and transform them into high performance team. Current undergraduate pathology teaching at Faculty of Medicine, Kassala University uses didactic lectures and tutorials. Objectives: To assess the feasibility and document our experience with TBL of systemic pathology among fourth year medical students at Faculty of Medicine, Kassala University. Methods: We introduced the 4th year (2011 - 2012) students (n=140) to TBL followed by dividing the students into teams of 5-7 students. We chose two courses of systemic pathology to be delivered as TBL. These two courses were divided into small topics. Each topic was mapped by academic staff and the outlines of the topics with the relevant references were given to the students 2-3 days prior to the team meeting. Each team was asked to prepare and research the topic before the meeting. On the meeting, the students were given pre-discussion individual assurance test (10 questions of best of five). Then the teams discussed the test and answered the test again as a team. Each student or team was asked to write an appeal (justification) if there was no consensus on the best answer. The whole class then met together to solve the assurance test and debate and respond to student's and team's appeals. Results: At beginning of the TBL there were some group cohesive problems; including: lack of punctuality, dominating students and quiet students. Once TBL became established, many of these difficulties were overcome. There was steep learning curve for the academic staff as well. The students and staff feedback was very positive. Conclusions: TBL can be applied in resource-limited countries. Overall, the feedback on TBL is positive.