Thermal spring health resorts around the world are repositioning themselves by moving away from medical treatments, and moving towards fitness and wellness, often accompanied by an increase in facilities for recreation. It is suggested in this paper that this represents a turning point for the thermal spring health tourism product, with the focus changing from using thermal water primarily for the treatment of illnesses, to helping already healthy people become even healthier. In the light of current developments, the historical development and geographical distribution of thermal spring tourism is discussed, with new developments highlighted, particularly those involving local communities. A historical overview of thermal spring health tourism is provided, starting with the ancient Greeks and their belief in the healing powers of water, and Roman bathing culture, where a symbiotic relationship between health and recreation developed. Recent trends in thermal spring tourism in most parts of the world, including sub-Saharan Africa, are explained. It is concluded that thermal spring health tourism has indeed turned a corner, and a new kind of product has emerged, where the medicinal properties of thermal waters are now being successfully used for wellness treatments. It is recommended that developing counties create thermal spring tourism products that combine thermal water resources with location-specific healing methods and remedies, but are extended to encompass surrounding natural and cultural attractions, and where possible, involve and benefit local communities.