Understanding the challenges of English for Medical Purposes (EMP) for Medical College teachers in Saudi Arabia is of crucial importance to improve their performance as ESP practitioners and that of EMP learners in general. The main purpose of this study is to investigate the challenges of the new EMP teachers in Saudi Arabia in teaching medical English via exploring the present situation analysis (PSA). This study follows a qualitative approach. Five EMP teachers and three deans of a medical college in Saudi Arabia were interviewed to identify new EMP teachers' challenges from linguistic and administrative perspectives. The study has found that new EMP teachers face difficulties, such as, adjustment of the English words in the medical context, pronunciation, and the meaning of the medical terminology. They also face medical background challenges, such as medical procedures, daily routine in medical institutions, and medical staff job descriptions. Pedagogical issues, such as, the methodology of ESP is another area the EMP teachers find difficulty in coping with. These findings highlight the first step to find solutions for these challenges to improve the performance of EMP teachers and their students.