While English as a medium of instruction (EMI) is becoming a widespread institutional practice across the world, how and by what strategies students whose first language is not English cope with EMI is under-represented. Drawing on data gathered through semi-structured interviews and reflective journals from 14 Mainland Chinese EMI learners in a Macau university, this study reports on the strategies used by students to cope with EMI learning. The findings yield empirical supports for the positive role of L1 in EMI learning. The findings call for a critical attention to the role of learner agency and contextual realities in shaping EMI learners’ actual strategy use in contexts.