Jane's options are good. It also depends on the context of the sentence. With and from are also possible translations of por medio de.
I've pulled some sample sentences from Google, and have given a possible translation for each:
Accesos directos por medio de teclado ...
Keyboard shortcuts ...
Por medio de la presente ...
By means of this letter ...
With this letter ...
Identificación de nombres personales por medio de sistemas ...
Using systems to identify given names ...
El origen de las especies por medio de la selección natural ...
Origin of species by natural selection ...
Verrugas: remoción por medio de congelamiento ...
Warts: Removal by freezing ...
Pedir Linux Ubuntu por medio de web ...
Order Ubuntu Linux on the web ...
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