In the lower primary classrooms in Ghana, most teachers are faced with the challenge of having to teach pupils from diverse ethnic and language groups. This qualitative study, therefore, investigates the practicalities of the instructional language policy and the role that English plays in multilingual classrooms at the lower primary schools. Accordingly, the research aims to find answers to the following questions. First, what medium of instruction does a teacher who does not understand the major L1 of that locality use during lesson delivery? Also, in a multilingual lower primary classroom where some pupils do not understand the dominant L1 spoken in the community, what becomes the medium of instruction? Finally, what role does English play as a medium of instruction at the lower primary level? In all, 53 participants were involved in the research. This number was made up of 14 teachers and 39 pupils sampled from three lower primary schools. Classroom lesson deliveries were observed, followed by semi-structured interview sessions with both teachers and pupils. The findings indicate that the classrooms are multilingual with the teachers employing the use of languages that they are comfortable with in teaching their pupils.