English-medium instruction (EMI) is increasingly common in educational contexts today, especially in higher education institutions (HEIs). The focus of EMI is primarily on the disciplinary content in courses rather than on the English language as a subject. HEIs choose to offer EMI for reasons such as internationalization and marketing, as well as providing students with exposure to the English language, although explicit language goals are not often articulated. In this chapter, EMI in relation to language ideologies, policy, student and teacher perspectives, and multilingualism is presented. Using the twin lenses of “parallelingualism” and “translanguaging,” the possible challenges to linguistic hierarchies and ideologies underlying EMI in Swedish HEIs are considered. The conclusion is that giving implementational and ideological space to languages that are currently not visible – including multiple local languages – may be a move beyond the binaries implied by a call for parallelingualism in the Nordic EMI context.