Background: According to the American Association of Medical Colleges, women comprise 26% of full professors and 19% of medical school department chairs. African American and Latino faculty comprise 4.6% of full professors and 6.9% of department chairs. Objective: Because of the lack of representation of women and racial/ethnic minority faculty at the highest levels of academic medicine, this study examines the perceptions of barriers to advancement by men and women academic medical school faculty of differing races and ethnicities to explore potential differences in perceptions by demographic group. Design: Semi-structured one-on-one interviews were conducted between July and September 2017. Participants: In order to give all faculty a chance to participate, faculty of all ranks and specialties were recruited from one southeastern medical school to participate in the study. Approach: Interviews were audio recorded, transcribed, and analyzed by 3 members of the research team using an inductive approach to thematic analysis. Participants were organized into 4 groups for analysis—underrepresented in medicine (URiM) women, majority women, URiM men, majority men. Key Results: Sixty-four faculty consented to participate in the study (56.2% women, 34.4% URiM). Subthemes were grouped under three main themes: Perceptions of Barriers to Advancement of Women Faculty, Perceptions of Barriers to Advancement of African American and Latino Faculty, and Perceptions of the Institutional Climate for Diversity. Majority men tended to voice distinctly different perspectives than the other three demographic groups, with the most notable differences between majority men and URiM women. Majority men tended to suggest that the advancement of women and URiM faculty was acceptable or getting better, the lack of URiM faculty in leadership was due mainly to pipeline issues, and women choose not to advance to leadership positions. Conclusion: We found that participant gender and race/ethnicity shaped perspectives of medical school faculty advancement in distinct ways.