In the third millennium, the tourism industry has become one of the most important, profitable, and fastest-growing global industries, playing a significant role in economic growth, job creation, and the enhancement of social welfare. The development of tourism, especially in less-developed countries, can not only contribute to reducing poverty and inequality, but also, through increasing direct and indirect revenues, provide the groundwork for improving quality of life and achieving sustainable development.Among the various forms of tourism, health tourism—and particularly medical tourism—has gained special importance due to its interdisciplinary nature, substantial economic role, and rapid growth over the past two decades. Medical tourism, as one of the main sub-sectors of health tourism, has quickly consolidated its position in the global market and has become a major trend in the healthcare industry.At present, many developing countries, recognizing the great potential and opportunities of this competitive market, have joined it and are seriously pursuing effective policies to increase their attractiveness as destinations for this highly profitable segment of the global tourism industry. Consequently, an intense competitive process has emerged to determine which countries will invest in and benefit from this rapidly growing global industry.Although healthcare-related travel or medical tourism is not a new phenomenon—and people have traveled to foreign lands for the treatment of diseases for thousands of years—its current pattern differs significantly from that of the previous century. Initially, this type of tourism mainly flowed from less-developed countries toward developed ones; however, in recent decades, due to rising healthcare costs in developed countries, advances in medical technologies in developing nations, and the substantial reduction in the cost of medical services in these countries, this flow has reversed.Today, many patients from developed countries choose destinations in Asia, Latin America, and the Middle East to receive high-quality and cost-effective medical care. The growing importance of medical tourism has led governments—particularly in the Asia-Pacific region—to initiate widespread competition to attract a larger share of this market.Iran, benefiting from advanced medical infrastructure, highly specialized physicians, and competitive treatment costs compared to other countries in the region, has emerged as one of the major medical tourism destinations in the Middle East. Studies indicate that the high quality of specialized and subspecialized medical services, together with the economic advantage arising from the low value of the national currency (the Rial), has placed Iran in a favorable position relative to many of its regional competitors. Nevertheless, the development of health tourism in Iran is still at an early stage. Achieving a desirable level of growth requires strengthening integrated management, improving physical and institutional infrastructure, developing national and international regulations and standards, and removing existing barriers such as banking and insurance challenges as well as communication and connectivity restrictions.In this context, Tehran, as the largest medical hub in the country and one of the most important healthcare centers in the Middle East, plays a key role in the development of health tourism in Iran. With its specialized and subspecialized hospitals meeting international standards, internationally recognized physicians, and advanced surgical centers, Tehran has a high capacity to attract foreign patients from countries such as Iraq, Afghanistan, Oman, Azerbaijan, and the Central Asian states. According to recent studies, Tehran accounts for the largest share of inbound medical tourists to Iran and is considered the most advanced destination in the country in terms of the diversity of medical services offered. At the same time, challenges such as the absence of a comprehensive and integrated health tourism system, weaknesses in international marketing, a shortage of accredited facilitation offices, and logistical and accommodation-related problems have imposed constraints on the development of this sector in Tehran.Therefore, a scientific examination of international tourists’ perceptions regarding service quality, travel motivations, perceived barriers, and the degree of conformity of Tehran’s medical services with global standards is a necessary step toward designing effective policies for the development of medical tourism in this metropolis. Considering Tehran’s strategic importance within the national healthcare system and its role in attracting health tourists, the present study analyzes the perceived quality and standards of Tehran’s medical services from the perspective of international tourists. Furthermore, by employing advanced statistical models, it seeks to propose an analytical framework for the development of health tourism in the city.

The results indicate that travel motivational factors play a central role in health tourists’ decision to choose Tehran. In addition, global standards of medical services and the level of medical knowledge and awareness of tourists have a positive and significant effect on destination choice. In contrast, structural barriers and constraints such as institutional, administrative, and infrastructural problems exert a deterrent effect on selecting Tehran as a health tourism destination.

These findings suggest that the choice of a medical destination is a multidimensional process based on perceptions of quality, trust, and ease of access. According to the results, the development of urban health tourism in Tehran requires a comprehensive approach that simultaneously focuses on strengthening travel motivations, improving the quality and standards of medical services, and reducing structural barriers. Implementing such an approach can enhance Tehran’s position as one of the major health tourism hubs at the regional level.