This chapter considers some of the theoretical foundations of teaching and learning in higher education and how these are reflected in practice. We consider how varying conceptions of teaching and learning with technology have an impact upon how teachers design teaching and learning. This chapter reviews why these variations are important and how they can affect the design of the curriculum and ultimately what and how students learn. We conclude that promoting increased use of technology does little, if anything, to improve student learning. It is only by attending to higher education teachers’ conceptions of teaching and learning with technology and supporting change in this area that significant progress will be achieved. In this chapter we advocate that informed design in the use of technology is underpinned by beliefs about (conceptions of) teaching and learning with technology. To this end the chapter explores some of the theoretical underpinnings of these conceptions and argues that they are fundamental to driving well-informed practice in the use of technology to support student learning.