The Italian Peninsula and its islands have always been the crucial crux in the movement of goods and people. Thanks to the mild climate and natural resources. The strategic position in the Mediterranean and the thousands of kilometers of coastline that allowed for the creation of safe harbors for ships, given the geographical conformation of the peninsula, before the Roman era, it was divided between several small kingdoms, including the Kingdom of the Etruscans. The latter knew the healing properties of thermal waters in present-day Tuscany and Umbria. The Greeks, in search of new pieces of fertile land, settled in southern Italy and Sicily. In Ischia, they discovered the benefits of local springs by building temples dedicated to divinities at each spa resort. But the real turning point in the exploitation of thermal resources came with the advent of the Romans: Roman doctors such as Galen, Celso, or Pliny classified the thermal waters based on characteristics and therapies. Numerous public Thermae were built for hygienic, recreational and curative purposes. Today we can find the remains of the baths throughout the national territory, for example, The Baths of Caracalla in Rome; the spa in the Euganean Hills area in Ischia, in Sirmione Terme, and many other places.

With the fall of the Roman Empire and with the spread of Christianity, which invited people to flee from hedonism, there was a decline of the baths as a cultural and social phenomenon, and during the Middle Ages, the thermal practice was limited to therapeutic use only. There are reports of the restoration of the springs and the enhancement of the spas in Abano, Salsomaggiore, and Montecatini. In addition to the bath and the hydrophilic treatment, they began to resort to the inhalation of vapor coming from the sources and the applications of the muds that deposited nearby.

The thermal cures gain greater fame during the Renaissance, thanks above all to the development of the press, which allowed a rapid spread of hydrological works. More specific actions were beginning to recognize the various types of water, and specific gynecological treatments introduced. In the fifteenth century, the illustrious doctor Ugolino Simoni from Montecatini founded modern hydrology. Among the characters, who visited the baths, stands Michelangelo, who in 1549 went to Fiuggi to treat kidney stones.

The eighteenth-century is the century of the experimental method also applied to hydrology, and the remarkable development of chemistry and physics allowed a more thorough study of the various waters. The spas were considered to be the real care centers.

Starting from the beginning of the 1900s, the spa resorts were transformed from health centers into resorts and social life, becoming a tourist product, recognized as thermal stations and cities able to attract customers from distant places. Frequented by the exponents of high society and aristocracy; therefore, the thermalism of the modern age defined as elite thermalism. This also had a noticeable reflection on the architecture of the centers: the luxurious and fascinating Liberty style could be admired in the spas, public buildings, high-level recreational facilities, parks, and gardens. In that period, dated 1890 to 1930, thermalism was of a "ludic" type because the spa mainly given the function of relaxation and entertainment, as well as a more general conception of "feeling good." In the fascist period, there was the c.d. Social thermalism, when the baths included in health policies recognizing the therapeutic use of thermal waters at a national level, this led in the second post-war period, to the thermalism assisted with the extension of the therapies, at contained costs. To the entire population, the treatments almost exclusively paid by the NHS. Since the 1980s, thermalism has undergone an evolution, passing from the concept of care and therefore of "social" or "assisted" thermalism to the idea of spas, intended primarily as health tourism to become the current wellness tourism, intended as a genuine holistic experience of caring for the psychophysical aspect of the individual. Nowadays, the practice of thermalism is associated with environmental education and enhancement of local and Mediterranean culture. We tend towards what is defined by the literature as a total quality of life.