Seventeenth-century Stuart queens consort were frequent visitors to English spas; primarily Wellingborough, Tunbridge Wells, and Bath. Anna of Denmark, Henrietta Maria, Catherine of Braganza, and Mary Beatrice of Modena sought mineral waters for gout and to encourage conception, solidifying a royal trend. While studies have addressed the social and political context of these visits, this article explores their medical treatment in the waters in regard to the purgatives, clysters, ointments, diet, and exercise that contributed to their cures. Occupying similar positions and even sharing doctors, the consorts’ use of the waters illuminates how treatments were tailored to their ailments. The article draws on the little-analysed notes of royal physician Theodore Mayerne, queens’ accounts, and spa guidebooks to argue that a holistic spa ecology of waters, earth, and air underpinned successful spa treatment. It also provides broadly applicable insights into the applied use of mineral waters in early modern England and beyond.