This chapter investigates the pedagogical and assessment-related consequences of using imported English as a Medium of Instruction (EMI) materials in Tunisia’s English as a Foreign Language (EFL) higher education. Grounded in a mixed-methods research design, the study draws on data from student and instructor questionnaires, semi-structured interviews, classroom observations, and document surveys conducted at a prominent business school. The findings highlight three interconnected areas of concern: first, the linguistic challenges students face due to misalignment between EMI materials and learners’ language proficiency levels, particularly regarding academic vocabulary, syntactic complexity, and pragmatic load. Second, the study reveals how imported materials shape classroom task design, often favoring abstract, decontextualized assignments that fail to scaffold students’ content and language learning. Third, assessment practices, particularly exams, tend to emphasize rote content recall over communicative competence or critical engagement, exacerbating inequalities in student performance. The chapter argues that implementing EMI in EFL contexts must move beyond content delivery toward a more inclusive, language-sensitive pedagogy. It advocates for the contextual adaptation of EMI materials, the integration of task-based learning (TBLT) principles, and assessment frameworks that align with both linguistic development and disciplinary learning goals. These findings are essential for language education policy, EMI curriculum design, and teacher professional development in multilingual, postcolonial higher education systems.