This book discusses the perceptions of staff and students with regards to the policy and practice of English as the medium of instruction (EMI) in Pakistani universities. Findings from qualitative and quantitative data collected in two public universities are compared to identify perceptions of problems concerning English as a medium of instruction for postgraduate study. The research also examines participants’ attitudes towards the use of Pakistani English (PakE), a distinct variety of English different from other dialects such as American English and British English in its various linguistic features, in higher education settings. The findings explore the gap between the policy and practice of EMI, and expose various multi-layered and inevitable issues.