Medical tourism is commonly perceived and popularly depicted as an economic issue, both at the system and individual levels. The decision to engage in medical tourism, however, is more complex, driven by patients’ unmet need(s), the nature of services sought and the manner by which treatment is accessed. In order to harness and promote the opportunities medical tourism offers, as well as address and contain attendant threats, an informed decision is crucial. This paper aims to enhance the current knowledge on medical tourism by isolating the types of decisions that patients make – and based on the existing literature, proposing a theoretical  sequence in opting for or against medical care abroad.  It proposes a sequential decision-making process to engage in medical tourism, which includes considerations of the required treatments, location of treatment, and the quality and safety issues that are attendant to seeking care.  Where patient involvement is regarded as crucial in achieving the desired health outcomes and promoting the efficient use of resources, the active role of the patient under medical tourism should prove to be valuable. In consideration of the challenges and opportunities that medical tourism offers, bringing forward scholarship on the globalization of health care in general and of medical tourism in particular, calls for developing empirical evidence on this increasingly popular and complex form of accessing and provision of medical care.