This chapter focuses on the number one issue of concern for medical tourism: quality, safety and potential harm for patients who travel abroad for treatment. While medical tourists seek shorter waiting times and lower costs abroad, we have limited knowledge about the factors that determine their decisions regarding quality and safety. As the number of medical tourists continues to increase and the availability of surgical and experimental treatments increases in more and more countries, limited studies from telephone interviews suggest that medical tourists choose destination hospitals based on proximity to home, aordability, physician experience and training, advertising and testimonials on social media. Although there is some indication that hospital accreditation may also inuence the decision-making process, the level of healthcare understanding necessary to make an informed decision and what constitutes ‘informed’ are yet to be standardised in this evolving industry (Crooks et al., 2010). Hospital providers and facilitators may oer a range of unveried claims about the quality of care and expected outcomes; however, the medical tourist is unable to assess and compare international hospitals for quality and safety. Other than accreditation, which is voluntary, there are no international regulatory standards for this industry. Hospitals that advertise themselves as ‘centres of excellence’ should provide evidence that they are knowledgeable and responsible for promoting safety and reducing preventable harm for their patients and sta. Currently, this obligation is ‘marketed’ but not suciently substantiated.