This article gives a Tunisian perspective to the ongoing debate on the adoption of English-medium instruction (EMI) across the globe and notably in the Middle East and North Africa (MENA). It explores the attitudes of students toward EMI, especially in relation to French, the default medium of instruction at Tunisian universities. It also investigates the challenges that students encounter in courses mediated through English. Finally, it reports on the current EMI practices as they are conducted in the classroom setting. The article uses a mixed approach involving quantitative data collected via an online survey and qualitative data via classroom observation and note-taking. It was found that students typically held a positive attitude toward English and an awareness of its importance. They displayed a pragmatic stance as they associated English with research, technology, mobility, employability, and career prospects. While English is used as the language of the curriculum and documentation, students engage in translanguaging practices to ensure an effective dialog with content teachers and better acquisition of academic content. Given their multilingual repertoire and the status of French, students used French and English in parallel and, to a lesser extent, Tunisian Arabic. They tended to switch to French to ensure a more effective classroom exchange, especially when English fails them. Teachers used translanguaging in order to promote students’ engagement in the academic content.