The purpose of this study was to examine pre-college piano students’ practice habits and their teachers’ perceptions of their practice performance in Eastern China. Data collected for this qualitative descriptive study included video recordings of five students’ individual practice sessions. Additionally, students ( n = 5) and their teachers ( n = 3) completed questionnaires and accepted semi-structured interviews. Findings indicated that pre-college piano students organized their habitual practice routines with task-oriented principles. Moreover, practicing hands separately was the most frequently applied strategies used by student participants. Given the intense peer competition within the Chinese education system, students not only learned practice strategies from their teachers but also acquired support from their parents and other external resources, such as practice tutors and apps, to improve their practice efficiency. However, noticeable differences were perceived between teachers’ expectations and their students’ performance. Teacher participants expected their students to apply practice strategies with flexibility, actively solve problems, and set specific practice goals during at-home practice. The findings can help piano instructors gain a better understanding of their students and use specific teaching approaches to address individual issues.