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This chapter analyzes the tourism industry from national and regional perspectives, in order to understand the past and current trends in Costa Rica’s positioning and branding attributes and strategies for tourism development. The intent here is not to provide an exhaustive comprehensive literature review of academic research on country branding; and so it is by all means a case study as it describes the evolution of the tourism industry in Costa Rica – including the transformative stages the country went through since the 1980s – as planned tourism national management programs evolved toward reaching the target of creating a nature-based tourism brand. The medical industry and then medical tourism industries are analyzed in a global basis and the US market is examined in detail because of its potential to develop a new complementary niche for Costa Rica’s tourism industry. The chapter intends to asses Costa Rica’s potential to become a country brand in medical tourism, leveraged on its natural tourism destination branding status quo.