The increased use of student internships and other forms of work placements in higher education programmes brings recognised benefits to students but also changes the risks for higher education institutions (HEIs) globally. This paper responds to the under-addressed problem for HEI managers of understanding the varying levels of risk of harm to students and HEIs, and the HEIs’ strategic responsibilities to understand how to mitigate the risk for both parties. We develop a typology of the main types of internship placements and theorise their associated levels of risk according to the HEI’s levels of responsibility and operational control. The risk types are then plotted in a model of risk mitigation, mapped against the frequency of their occurrence and the severity of their impact, with a focus on HEIs and students. We conclude with practical and policy implications for HEIs and their managers. Our paper argues that HEIs must balance their risks and responsibilities with the costs and benefits of student internships and work placements, and contributes to understanding potential gaps between HEI strategic decision-making and operational practice at the programme level, along with solutions to address these.