Abstract: This study investigates the challenges and opportunities of implementing English as a medium of instruction (EMI) at Vietnamese universities, addressing the gap in understanding how EMI programs operate in Vietnams specific educational context. This study aims to identify the main barriers and factors that facilitate the successful implementation of EMI, and explore potential solutions for improvement at the organizational, faculty and student levels. Using a qualitative approach, the study collected data from 5 major Vietnamese universities through semi-structured interviews with 15 managers, 20 lecturers, 30 students, and 5 policy makers, supplemented by 6 focus group discussions and 20 classroom observations.