The development of English as Medium of Instruction (EMI) at the tertiary level has been accelerated by the ever-increasing degree of higher education internationalisation. The study, based on a survey with 112 students and semi-structured interviews with 16 instructors collected at a Sino-foreign cooperative education institution in China, explores students' perceptions of and adaptation to EMI teaching and learning. The findings indicate that students show a positive attitude towards EMI teaching and learning. Students' motivation and prior English proficiency are important factors that influence their learning experience through EMI. Tailored pedagogical strategies to facilitate students' learning, an enhanced level of collaboration between EMI teachers and language teachers, and the provision of an immersive sociolinguistic environment conducive to EMI are also instrumental. The study suggests a range of strategies and policy implications that might benefit EMI teaching and learning in non-Anglophone countries that are keen on higher education internationalisation.