Over the last decade, modern society and various economic actors have faced risky instabilities, trials and challenges due to increasing globalization and the emergence of various global crises. Considering the last five years to date, management in the tourism sector is by no means immune from the unexpected threats, economic and health crises that continue to negatively impact all processes and future business development prospects. The need for the emergence of a new economic concept of risk and its management has been identified as urgent. The rapid development of tourism in the country and the absence of an adequate risk management strategy lead to the emergence of a number of undesirable consequences, aggravation of existing problems and generation of numerous adverse trends in the tourism and hotel industry in the country. The object of the study is health tourism in the hospitality industry in Bulgaria. The hotel product is complex, designed to satisfy the needs of guests. Composed of different elements, this paper focuses and analyses the complementary product, which with its service complements and enriches the final needs and satisfaction of the customer. Medical Spa Centres, as the subject of the study, are an example of a pulling force in the choice of a destination in health tourism. They improve economic growth, industry competitiveness and stimulate tourism consumption. The processes in the Medical Spa Centers are strongly influenced by the surrounding external and internal environment, working together under the wing of the hotel complex. Respectively, they increase the valuation of the economic entity, contribute to higher financial performance and at the same time satisfy various human needs of a health and wellness nature. The role and importance of Medical Spas has been proven in the development of the hotel product, therefore the need to implement strategic management approaches to address risk and unexpected threats should be analyzed. The methodology is based on a systematic approach and on different research methods, including: theory, publications, analysis and systematization. The empirical research was conducted through in-depth interview with managers of hotel complexes with Medical Spa centers to identify threats and risks typical for health tourism, and ways to overcome them in their organization with actual management measures. The last part of this paper analyzes the application of a model risk management system for a hotel tourism enterprise and the need to implement such a standard in our country.