Purpose: The purpose of this study is to systematically analyze the evolution of health tourism development, identify relevant themes and segments of health tourism research and offer future research directions and practical implications for academic researchers and tourism practitioners worldwide using China as an example. Design/methodology/approach: Using a bibliometric analysis, the present study comprehensively analyzes the theme, segments and the evolution of health tourism research over the past 40 years in China. Findings: Major findings show that health tourism research in China could be divided into four stages with different characteristics, and three segments, including wellness tourism, health and wellness tourism and medical tourism. Findings also reveal the trend of health tourism development tends to be industrialized, diversified and systematic under the guidance of recent policies. Theoretically, based on the theoretical framework developed by Hall (2011), the present study contributes to the establishment and extension of the framework for health tourism within the context of China. Practically, findings can provide health tourism-related policy implications for the future development of health or health sector-integrated tourism. Research limitations/implications: The study proposes possible collaboration between government and academia in terms of health tourism-related policy formulation. Originality/value: Through 40-year bibliometric analysis of health tourism evolution in China, the present study explores the main themes of health tourism development, identifies the segments of health tourism and analyzes the development stages of health tourism. Findings should be of use to international readers to better understand the uniqueness of health tourism development and find out possible future health tourism development research directions. As a result, major contributions of this paper are the comprehensive analysis of the evolution of health tourism research and the implications on other countries and regions to adopt a pragmatic approach to explore the trend and unique characteristics of health tourism for future development.