The aim of this study is to conduct a need analysis for the first-year medical students at the University of Kordofan. The learners need English language during their study at the Faculty of Medicine and for their future careers. Considering the learners` needs will make learning easier and help teachers to teach effectively. The study used a quantitative and qualitative method, since the data are collected via means of two instruments, a questionnaire for the students, and an interview with the teachers. The sample of the study from which subjects were drawn can be divided into two categories; students from the Faculty of Medicine and other medical specializations (80 students) and teachers who teach at this college (10 teachers). The data obtained was analyzed by using the Statistical Package for Social Science (SPSS). The findings showed that medical students and other medical specializations at the University of Kordofan are not satisfied with the current English language course and it does not meet their language needs, the teaching staff were agreed that the current English syllabus does not cope sufficiently with the students' medical English needs and the ESP programme is suitable for them. So, the study also found out that English language is important for them in their university studies and in their future careers, English language courses at the Faculty of Medicine should be relevant to medicine. The study is concluded with a set of recommendations including: there is strong need to have a high level of English language proficiency to perform medical job effectively, also. The researcher recommends that further research should be conducted to design an ESP programme based on this needs analysis, Medical students need to be updated to cope with the current changes in the field of medicine. Students should consult references and search their way to be autonomous learners English courses in Faculties of Medicine should focus on the major English language skills and give priority to communication skills.