The aim of this research is to describe and analyse four different strategies for the internationalisation of healthcare. We have looked at four major international hospitals that have taken alternative routes to reach a global health care market. The Mayo Clinic, Johns Hopkins Hospital, Karolinska University Hospital and Singapore General Hospital are all receiving international patients, but are pursuing different approaches to the international marketing of healthcare. We have conducted a large number of in-depth interviews with representatives for these hospitals and present four comparative case studies of the internationalisation of health care and what has become described as medical tourism. A growing number of patients are today seeking healthcare outside their country of residence. International health care is today one of the fastest growing industries with an annual growth rate of more than 20 per cent. Understanding the dynamics of this potent globalization is essential to researchers of international business. We have identified three modes of services offshoring development and two variables that have been essential to the understanding of hospitals internationalisation. First, the price range they are operating which determines which international markets they can penetrate. Secondly, the stage to which they have come in their internationalisation which influences movements into international markets. The four internationalisation strategies represent four distinct corners in a two by two matrix.