The concept of the business ecosystem emerged at the turn of the century, drawing inspiration from biology to describe the economic community. Since its inception, this concept has found applications across various domains, including technology, innovation, and entrepreneurship, where it significantly contributes to strategic management. However, within the realm of tourism, there remains a notable dearth of literature on this subject. While it is acknowledged that tourism destinations embody many characteristics of a business ecosystem, concrete tools for adopting an ecosystemic approach in tourism management, particularly across different tourism types, are lacking. The current study seeks to address this gap by undertaking a theoretical exploration of health and recreational tourism. It aims to identify socio-economic aspects that could facilitate the adoption of an ecosystemic approach in the governance of tourism destinations, with a specific focus on these types of tourism. As a result of this endeavor, an initial model delineating the ecosystem of a health and recreational tourism destination is proposed. This model lays the groundwork for empirical validation and further refinement through subsequent studies.