Purpose - The purpose of this theme issue is to explore the development of health tourism in challenging times, with a particular focus on the Visegr & aacute;d countries. The issue investigates the ways in which health tourism enterprises and destinations can enhance resilience, adapt to post-pandemic conditions and navigate economic, social and political uncertainties. Additionally, it highlights the role of health tourism in improving individual and community well-being while aligning with the principles of sustainable development. Design/methodology/approach - This theme issue employs a thematic approach, incorporating both theoretical and empirical perspectives on health tourism development. The research articles included in this issue utilize various qualitative and quantitative methodologies, such as case studies, survey-based research and Delphi studies. The focus is on examining the sustainability and resilience of health tourism enterprises and destinations in the Visegr & aacute;d countries, drawing on data from key stakeholders, including industry professionals, policymakers and researchers. Findings - The studies presented in this theme issue identify several critical aspects of health tourism development in the Visegr & aacute;d region. Key findings include (1) the increasing significance of health tourism as a tool for regional economic development and social well-being; (2) the necessity of infrastructural improvements and service diversification to attract both domestic and international tourists; (3) the role of strategic collaboration between stakeholders, including policymakers, businesses and healthcare institutions, in ensuring the long-term viability of health tourism; (4) the importance of sustainable practices in health tourism management, particularly in light of climate change and resource conservation challenges and (5) the evolving consumer behaviour patterns in the post-pandemic era, which emphasize wellness, preventive healthcare and personalized experiences. Originality/value - This theme issue contributes to the growing body of literature on health tourism by addressing gaps in research related to the Visegr & aacute;d countries. It provides novel insights into the resilience and adaptability of health tourism enterprises and destinations in the face of global crises and economic fluctuations. By offering strategic recommendations for policymakers, industry practitioners and researchers, this issue fosters a deeper understanding of how health tourism can drive regional development and support sustainable growth in uncertain times.