A major spatial element of tourism impacts is that, although they can take place almost anywhere, they tend to be concentrated in certain areas. Such areas may be referred to as tourism resorts, tourism areas or tourism zones. However, the concept that has been used increasingly to suggest the main focus of tourism impacts is that of the tourism destination. This chapter presents tourism impacts in destinations, prior to a consideration of planning and management in such locations. Several examples and case studies focusing on urban and coastal destinations are used, in particular, to investigate the role of Destination Management Organizations in relation to planning and management.