The Dalton Plan, an educational approach centered on student autonomy through assignment contracts and self-paced learning, offers a potential alternative to traditional teacher-center instruction. This study examines its application within the challenging context of Chinese College English (CE) reading courses, where students often struggle with academic reading comprehension and lack self-regulation skills. A quasi-experimental design was employed to evaluate the impact of Dalton Plan-based instruction on the reading performance and learner autonomy of 31 second-year medical students. Participants were divided into a control group (n=15) receiving conventional instruction and an experimental group (n=16) receiving Dalton Plan-based instruction, which emphasized independent reading assignments with tailored teacher guidance. A mixed-methods approach collected quantitative data (reading tests, Autonomous Learning Scale) and qualitative data (thematic analysis of student self-reports). Results indicated that Dalton Plan-based instruction significantly enhanced learner autonomy; however, its effect on reading test scores was not statistically significant. Thematic analysis of self-reports revealed a developmental trajectory from initial challenges—such as time management and vocabulary inadequacy—to later progress in reading interest, strategy use, and persistence. These findings not only provide pedagogical insights for innovating reading instruction in Chinese EFL (English as foreign language) contexts but also highlight the complex relationship between fostering autonomy and achieving measurable gains in reading proficiency.