Research conducted in the 1980s and 1990s pointed to a widening gap on Hong Kong university campuses between institutional language policy, which stipulated the use of English, and classroom practice, which often involved the use of Cantonese to explain and discuss English written materials. This article presents the findings of a multidimensional study which sought to uncover patterns of in-class and out-of-class language use at one officially English-medium institution between 2000 and 2010 and to identify the challenges that its mainly Cantonese-speaking undergraduates experience when listening to and speaking English for academic purposes. The findings were derived from two campus-wide questionnaire surveys and an interview-based longitudinal study of the student experience of English-medium higher education. The findings indicate that the gap between policy and practice has closed noticeably in the past decade in consequence of the increasing internationalisation of the student body and institutional initiatives to enforce the medium-of-instruction policy. While there is a closer, though not watertight, alignment between policy and practice in lectures and seminars, the evidence suggests that students have little need or desire to speak English outside the classroom, apart from situations in which international students or non-Cantonese-speaking students from mainland China are present. [Copyright of Language and Education is the property of Routledge. Full article may be available at the publisher's website: http://dx.doi.org/10.1080/09500782.2011.553287]