The spa industry is a booming business that is growing in popularity and profitability, and the outlook for the future is promising. The Republic of North Macedonia is a country with about 60 springs of mineral water that has eight thermal baths, from which two are currently not in operation. When comparing with some European countries, it can be seen that in Serbia there are more than 50 baths and more than 1000 springs, of which about 500 springs of cold and hot mineral water as well as an abundance of mineral mud. According to the number of overnight stays and arrivals, spas are leading tourist destinations in Serbia. In Croatia, unfortunately spa tourism is poorly developed taking that Croatia faces the Adriatic Sea (which is one of the calmest and clearest in the Mediterranean) and is the main tourist attraction in the country. Spa tourism is the most developed in Hungary where there are more than 100 spring of mineral water, currently there are 230 thermal baths. In Slovenia, one of the most developed forms of tourism is spa tourism. There are 87 thermal water springs with different properties and temperature (from 32 to 73 degrees Celsius). Slovenia currently has 12 SPA centers. Purpose: The purpose of this paper is to see the number of overnight stays in the spas, compered to the total number of overnight stays of all types of tourists in the Republic of North Macedonia, but also in some of the European countries. This paper covers the countries of Serbia, Croatia, Hungary and Slovenia. Methodology: To achieve the set goal, the methods that were used are analysis and retrospective analysis of the number of spa tourists, the number of overnight stays in spas and the total number of overnight stays of tourists in the Republic of Macedonia and some of the European countries for the period from 2010 to 2020. The data were collected by the State Statistics Office of the Republic of Macedonia and related to the researched countries, and they were processed tabularly and graphically. The analysis was performed on the basis of previously studied scientific theoretical content of materials that include: literature, books, magazines and newspapers, reports, relevant publications, on line databases, as well as all other published materials. Results: For the period from 2010 2020 the biggest number of overnight stays were Hungary (1 113 300 000) ) from which 44.45% were from the spa tourists. The Republic of North Macedonia for these 10 years has a total number of overnight stays 26,465,259, of which 7.71% are overnight stays in spas or 2,041,044. Conclusions: The percentage of overnight stays in spas compered to the total number of overnight stays for the Republic of North Macedonia is 7.71%. The biggest number of overnight stays by spa tourists were in Hungary (44.45%), and the lowest number were in Croatia (0.6%).