In the last decade, Battery Electric Vehicles (BEV) have been detected as a way to decrease greenhouse gases emission related to road transportation. Still, this technology faces several problems to break through the current automotive market because of the poor autonomy compared to ICE (Internal Combustion Engine) vehicles and of the average cost. These two issues are highly influenced by the design and the operation of the vehicle thermal management system. Auxiliary loads, heating and cooling demand can drastically decrease the BEV autonomy but also electric components lifetime because of inefficient cooling/heating resulting in improper operating temperature. Extensive scientific work has been performed to optimise the Vehicle Thermal Management System (VTMS) for electric/hybrid cars. However, the application of the found results or developed methodologies to Medium Duty Electric Vehicles (MDEV) has only been scarcely discussed so far. Hence, this paper proposes an insight on the scientific issues to be addressed to achieve an optimal design of MDEV thermal management system.