The concept of sustainability as it applies to cultural tourism is discussed in this chapter. Ideally, sustainable cultural tourism should involve a partnership that satisfies both tourism and art / cultural heritage management stakeholders. However, past practices suggest that this objective is hard to achieve, as usually a trade-off occurs to the detriment of one sector and the benefit of the other. The chapter discusses the triple or quadruple bottom line approach to sustainability that includes economic, ecological, social and cultural considerations. Reference is also made to the impact of climate change and how it will influence the evolution of the sector. The chapter then continues to discuss the parallel evolution of tourism and cultural management, which leads into a discussion of their role as potential collaborators or competitors. Six possible relationships that exist along the conflict / partnership continuum are then discussed. Full partnership represents one end while open conflict represents the other end. The consequences of this relationship are explored.