This study was conducted to explore the practices of English teachers in teaching English at the middle level. Using a qualitative case study method, the study was conducted in a public school in Hunza, Gilgit-Baltistan. In this study, the primary research participants were three teachers teaching English at the middle level and nine students, three from each of the following grades: 6th, 7th, 8th. The data were generated through semi-structured interviews, classroom observations, focus group discussions and field notes. Case-oriented replication strategy was used to analyze the data. The research location was chosen keeping in view the socio-economic status and language similarities in the teaching and learning of English in the context where the research problem occurred. The major findings reveal that English teachers use the Grammar Translation Method (GTM) for teaching English. During lesson presentation, it was observed that teachers follow the old method of translating the text from English to Urdu and ask students to learn it by heart. Moreover, the teachers' interaction with the students is most of the time bilingual or sometimes translation from English to Urdu, whereas students completely use Urdu language in interacting with their peers and teacher. The particular method which the teachers use for teaching English is ineffective for improving students' English language competence, particularly in developing communicative skills. Therefore, students experience difficulty in expressing themselves effectively in English language. The reasons behind this practice in the teaching of English are: lack of subject specialist teachers, curricular overload, lack of ongoing support system, teachers' inefficiency, shortage of resources and lack of professional development opportunities. To sum up, the findings of this study indicate that there is a dire need to bring improvement in the practice of teaching and learning English. Therefore, the study ends with some recommendations offered for the purpose of the said improvement.