With the internationalization of higher education, more Chinese students are pursuing their postgraduate study in English-medium instruction (EMI) institutions abroad. Related studies have mostly investigated EMI policies and implementation and students' attitudes; however, they have not examined how Chinese students cope in English-as-a-second-language environments, specifically in academic writing. This study examines Chinese students' perceptions of English academic writing, difficulties, and coping strategies to complete academic writing requirements in Malaysian universities. Respondents, totalling 128, filled out a 51-item questionnaire. T-test was used for data analysis, and nine students were selected for qualitative interview. The results indicate significant differences in participants' chances of practicing English writing before and after studying in Malaysia. Although they experienced challenges, such as insufficient prior English writing practice, lack of knowledge in English academic terms and expressions, and difficulty in identifying research gaps, they succeeded with help from teachers, peers, and workshops. Implications for EMI are provided.