Medical tourism, although being considered a recent phenomenon in Brazil, still represents an important opportunity for institutions that have health facilities, human resources and advanced technological level. This work aims to develop a reflection about this market based under the innovation theoretical perspectives. In order to support this analysis was conducted a multi case study in four health institutions located in the Brazilian south region. Results confirmed that these institutions developed innovations, classified as innovation in product, process, organizational and marketing. Moreover, the evidences indicated that the institution participation on medical tourism market, using innovation as a competitive advantage, helps to promote a new business design and organizational processes, adequate infrastructure, assigning a due importance to the marketing and management sectors, generating an external recognition, a larger network relationships, cooperation among peers, ensuring to these institutions an international standard of service delivery.