INTRODUCTION: Medical ethics teaching is one of the pillars of medical education. Ethical reasoning learning (ERL) is one of the means of teaching medical ethics. OBJECTIVE: The aim of our study was to evaluate the pedagogical interest and the students' perceptions of ERL in directed teaching in internal medicine among fifth-year students. METHODS: This was a cross-sectional study conducted in the Internal Medicine Department of Habib Thameur Hospital during one academic year. The pedagogical interest and the student's perception were evaluated by comparing a pre-test and a post-test filled in by the students, respectively, before and after an ERL session. RESULTS: Our study included 44 students. Before the ERL session, almost two-thirds of the students (63.6%) found the ERL to be "extremely interesting" in medical training and practice. This extremely high level of educational interest in the ERL was statistically associated with previous participation in ERL sessions among our students. Prior to the ERL session, just over four-fifths of the students (84.1%) had a "favourable" perception of the ERL. After the ERL session, our study noted an improvement in students' pedagogical interest in ERL. Our study also showed an improvement in students' perceptions of the ERL. The improvement in students' pedagogical interest and perception of ERL exceeded 80% after the session. CONCLUSION: Our study concluded that there was a significant pedagogical interest and a favourable perception of the students' point of view regarding the ERL in internal medicine- directed teaching among fifth-year medical students.