The tourism market for health resorts is changing fast throughout the world. The ageing population, the growing interest for wellness and health, care for body and mind, and the search for new experiences and meanings force traditional health resorts in particular to adjust the products they offer within the triangle of health treatments, recreational activities and cultural entertainment. Traditional spas, above all, possess an extremely rich variety of tangible and intangible cultural heritage elements, as well as valuable natural and cultural resources. The authors propose that these elements need to be identified and valorized in order to develop the spas further. The arguments presented are supported by four case studies Karlovy Vary and Mariánské Lázně (Czech Republic), Abano Terme (Italy) and Spa (Belgium) all of which were famous spas frequented by the European elite in the 18th century, but had fallen behind modern developments in spa tourism by the end of the 20th century. The main conclusions are that all four spas are now in the situation of having to design and apply revitalization strategies. In these, not only the development of infrastructure, on which most of the emphasis had been placed in the past, is necessary, but also more attention should be given to the potential contribution of intangible heritage, to which less consideration had previously been given. © 2008 Nova Science Publishers, Inc