This paper presents the results of morphological and microclimatic surveys and speleothem analyses of ten karst caves located in different isles in Ha Long Bay, a famous tourist attraction in Vietnam. Characteristically, the caves have enormous entrances, roomy interiors, but short length, typical of karst caves in tropical climates. The cave microclimate was found to be significantly dependent on the outside atmosphere and human activities. There was a clear spatial variation in macro features and fabrics of speleothems from entrance (porous, microcrystalline) to rear (solid, macrocrystalline) of the caves. Microstructure analysis with the use of an environmental scanning electron microscope shows a gradual decrease of biological activity and microclimate instability from outside to the innermost parts of the caves are the causes for this spatial variation. Past and present deterioration of caves and speleothems directly due to tourist activities and vandalism has been observed. On the other hand, there are signs of speleothem regrowth in the caves where tourism has been stopped. This study has proved that caves and their speleothems in Ha Long Bay are highly dynamic and understanding of their environment requires immediate methodological attention. Based on the analytical results, it is recommended that regulation of visitor frequency and removal of lamp-flora are necessary for sustainable development of the show caves and their speleothems.