In Malaysia, a country that ranks among the world's most recognised medical tourism destinations, medical tourism is identified as a potential economic growth engine for both medical and non-medical sectors. A state-level analysis of economic impacts is important, given differences between states in economic profiles and numbers, origins, and expenditure of medical tourists. We applied input–output (I–O) analysis, based on state-specific I–O data and disaggregated foreign patient data. The analysis includes nine of Malaysia's states. In 2007, these states were visited by 341,288 foreign patients, who generated MYR1,313.4 m ($372.3 m) output, MYR468.6 m ($132.8 m) in value added, and over 19,000 jobs. Impacts related to non-medical expenditure are more substantial than impacts related to medical expenditure, and indirect impacts are a substantial part of total impacts. We discuss management and policy responses and formulate recommendations for data collection.