Middle-income countries show significant interest in adopting dual vocational education and training (VET) as a “best practice” approach to address both social and economic objectives. However, they face significant interests-based and institutional constraints when implementing dual VET. They lack well-established intermediary organisations at the meso-level that can assume key coordinative tasks needed to overcome typical cooperation challenges in dual VET. Nevertheless, country case studies from Latin America and Eastern Europe shed light on locally-adapted approaches contributing to increased cooperation in VET. These approaches can be broadly categorised into macro-level top-down strategies, meso-level sectorial initiatives, and micro-level bottom-up interventions. While these strategies cannot fully resolve all cooperation issues, they represent second-best resolution strategies effectively fostering cooperation and innovation in VET.