Student-run asylum clinics within medical schools represent a promising alternative to costly medicolegal services for people seeking asylum by providing pro bono forensic medical evaluations. However, there exist significant operational barriers to creating and developing such clinics, which depend largely on volunteerism and limited financial budgets. This policy and practice note not only presents a framework aimed at navigating these barriers in developing a student-run asylum clinic but also outlines critical challenges and recommendations for addressing them. We describe three principal components of clinic structure: community outreach and service, administration of forensic medical evaluations, and continuity of care. We also highlight challenges, such as access to a physical space for evaluations, maintenance of interpreter access and quality, standardization of clinician evaluator expectations, clinician evaluator availability, and evaluator wellbeing. Recommendations include the incorporation of a diversity of referral sources, opportunities for clinician-clinician shadowing, evaluation quality assessment, affidavit standardization, and development of interdisciplinary partnership.