This study explores the alignment of English for Specific Purposes (ESP) instruction in vocational high schools (SMK) with the communication demands of the manufacturing and healthcare industries in Gresik Regency, Indonesia. Employing a qualitative case study approach, data were collected through interviews with teachers, students, and industry representatives, classroom observations, and document analysis. Findings reveal that students in pharmacy and technical departments require specific English skills such as reading technical manuals and medical charts, writing reports, and engaging in professional oral communication. However, the current curriculum still emphasizes General English, resulting in a gap between school preparation and workplace needs. Teachers face challenges including limited ESP-specific materials, lack of training, and constrained class time. Meanwhile, industry stakeholders emphasize the importance of technical vocabulary and oral communication skills. The study underscores the urgency of curriculum redesign, the development of specialized ESP modules, and stronger collaborations between schools and industries to improve students' work readiness.