The healthcare delivery systems in India encounters significant waste in the form of long patient waits, unnecessary paperwork, duplicative diagnostic tests and shortage of supplies. Today, more than ever before, the pressure is increasing on international healthcare providers to provide high-quality care while improving efficiency and reducing cost which can be achieved by adopting Six Sigma. The study was carried out with the objective of making out a case for implementing Lean Six Sigma Methodology in hospitals marketing Medical tourism is a lucrative sector for many destination countries, particularly developing countries like India. In today’s competitive environment, the main concern for medical tourism practitioners and managers is to identify ways and means for attracting new medical travelers through marketing and motivating them to make repeat purchases through service efforts and strategies. However, return of international patients to the hospital and destination country for medical treatment depends greatly on product and service quality experiences of patients during earlier treatment and less on International Accreditations. This paper presents a case study of the implementation of lean six sigma techniques through two projects carried out in a leading hospital promoting medical tourism in Kerala.