The medium for teaching and learning in South African universities is not the mother tongue of the majority of students and this has been reported to be a barrier to achievement (Department of Education, 2002). Poor English language skills, as well as poor discipline specific vocabulary knowledge, can lead to poor study techniques with the students resorting to rote learning as they are unable to interpret the recommended texts (Gow, Kember, & Chow, 1991; Shembe, 2002). In 2005 at the NMMU a significant difference was reported between the marks achieved for the Pharmacology 2 (ZCL2) module by English first language (EFL) students and the English second language students (EAL) (Boschmans & McCartney, 2005). These finding provided motivation for this study which interrogates issues of language and learning in a multilingual Pharmacology classroom. A mixed methods approach, which employed a concurrent triangulation design with quantitative dominance, was used. Two parallel studies were undertaken. One consisted of a quasi-experimental, pre-test and post-test control group design using an intervention which consisted of the application of the didactical practice of exploratory talk with an experimental sample group during ZCL2 Supplementary Instruction sessions (SI). A second study involved a parallel data collection from the ZCL303 and ZCL401 Pharmacy students at the NMMU to investigate possible effects of academic progression. Purposive, homogenous sampling was used in selection of the samples. The mean ZCL2 mark for the experimental group (58.70±14.14 percent) of students who experienced the intervention (application of exploratory talk) was significantly higher (p = .0004) than the mark achieved by the ZCL2 comparison group (46.47±14.48). This Abstract difference was of high practical significance (Cohen‟s d = 0.85). This quantitative finding was supported by the qualitative data where the students expressed support for the discussion sessions (application of exploratory talk) held during SI sessions. There was a significant increase, with academic progression, of English reading comprehension amongst the EFL students (p = .025) but not in the EAL students and BPharm1 weighted average (p < .001) as well as SI attendance (p = .02) correlated significantly with achievement in ZCL2. The findings of this study provide insights into the teaching of Pharmacology in a multilingual classroom. The qualitative results in addition to strengthening the quantitative findings through triangulation have provided a rich, deep and detailed description of the lived experiences of Pharmacology students. The data will provide insights into students‟ experiences for Pharmacy academics and are a resource for understanding student perspectives.