This article discusses the use of appropriate medium of instruction in multilingual classroom contexts, which is one of the most debated issues in education around the world. It first briefly overviews mother tongue education in relation to English language teaching in Nepal. Then, presenting a case study from Nepal, it offers theoretical insights about the use of mother tongue for higher education in general. Given that the issue of language of instruction is less often questioned in higher education around the world, it calls for such a discussion by drawing insights from the use of English, a foreign language, as the medium of instruction at different levels of education in Nepal.