The discourse on English-medium teaching in higher education uses several terms and concepts to describe practices, very often synonymously. This contribution aims to fill the research gap of a conceptualisation of English-medium teaching in higher education. It will identify relevant approaches and their corresponding terminology, as well as clarify which approaches are most suitable for higher education. Given that the past decades have seen a substantial rise in the use of English as a teaching language in European compulsory schooling [Dalton-Puffer, C. 2011. "Content and Language Integrated Learning: From Practice to Principles? Annual Review of Applied Linguistics" 31: 182-183], the paper will also draw parallels between the secondary and the tertiary levels of education. At the same time, it will also be shown why insights drawn from research conducted in secondary education cannot simply be transferred to the tertiary level of education. The main focus of the paper is on the 'English-medium Paradigm,' a framework created to identify prevalent instructional types in English-taught programmes at universities in non-Anglophone countries [Unterberger, B. 2014. "English-medium Degree Programmes in Austrian Tertiary Business Studies: Policies and Programme Design." Dissertation, University of Vienna, 45--52]. The paradigm is based on terminological and conceptual considerations gained from the critical discussion of English for specific purposes, English for academic purposes, Content and language integrated learning and English-medium instruction literature [e.g. Bhatia, V. K. 1993. "Analysing Genre: Language use in Professional Settings." London: Longman; Hyland, K. 2006. English for "Academic Purposes: An Advanced Resource Book." London: Routledge; Dalton-Puffer, C. 2007. "Academic Language Functions in a CLIL Environment." In "Diverse Contexts - Converging Goals: CLIL in Europe", edited by D. Marsh, 201-209. Mehrsprachigkeit in Schule und Unterricht 6. Frankfurt am Main: Lang; Dafouz, E., and U. Smit. 2014. "Towards a Dynamic Conceptual Framework for English-medium Education in Multilingual University Settings. Applied Linguistics". doi:10.1093/applin/amu034]. The paper therefore provides a timely conceptualisation of the varieties of English-medium teaching in higher education which also takes into account pedagogical considerations as well as implications for curriculum design.