ABSTRACT This study aimed to analyze the performance of medical tourism in Iran using importance–performance analysis (IPA). In this cross‐sectional study, five hundred ninety‐six medical tourists from West Asian countries (Iraq, Azerbaijan, Kuwait, Qatar, Bahrain, Oman, Syria, Lebanon, Oman, Saudi Arabia, and Yemen) referring to health centers to receive medical services in Iran in 2020 were recruited. A standard IPA questionnaire was used for data collection. IP gaps were negative in all three attributes (medical treatments and service attributes, destination attributes, and tourism‐specific attributes). Respondents attached the highest importance to medical treatments and service attributes. The highest IP gap was related to medical treatments and service attributes. The results highlighted that the Iranian tourism industry is not performing well in many areas. Tourism managers and stakeholders should adopt useful strategies for improving those areas with high importance and low performance.