PurposeThe major purpose of this research note is to explore some of the potential biosecurity and nosocomial risks associated with international medical tourism.Design/methodology/approachThe note reviews relevant medical tourism and cognate literature.FindingsThe note finds that there are substantial risks associated with nosocomial infections and complications as a result of international tourism. Although these are clearly significant at an individual level they also represent significant biosecurity risks to the home country of medical tourists and particularly to medical facilities which they may visit if they have an infection. Medical tourists are therefore identified by the medical community as posing significant risks for the spread of pandemics, as well as further contributing to increased antibiotic resistance. Further systematic research is required to assess risk management strategies including the appropriateness of international and national regulations which currently shows considerable variability.Social implicationsThe development of international medical tourism is demonstrated to have potentially significant negative implications for global public health.Originality/valueThe relevance of the paper lies in its identification of considerable risks associated with international medical tourism which may have considerable economic and personal costs associated with them. Such risks are not usually incorporated into assessments of the economic benefits of medical tourism.