This paper reports on a rigorous literature review of research into medium of instruction in Ghana and India, whose language-in-education policies represent two contrasting models of use of local languages and the development of competence in English. The paper begins by briefly overviewing the language-in-education policy in these two countries and sets out the methodological approach underpinning this review. It then turns to the initial findings, which are discussed in two parts: the first categorises the three areas of research explored in the empirical studies reviewed, namely the effectiveness of language-in-education policies, problems hindering the implementation of these policies, and attitudes to these policies. The second provides an overview of the recommendations for how, given the obstacles in implementing the current policies, to better ensure the effectiveness of language-in-education policies in Ghana and India. Together these findings show that similar issues arise that contribute to challenges of providing equitable, quality education, and similar recommendations have been put forward as a result. This paper thus provides a valuable overview of key issues in the role of language-in-education policies in improving equity and quality in education in LMICs.