While scholars increasingly acknowledge that most contemporary international medical travel comprises South–South flows, these have gone curiously unexamined. Rather, policy, scholarly and media attention focuses predominantly on North–South flows of ‘medical tourists’. However, this focus diverts attention from the actual and potential impacts of South–South intra-regional medical travel flows on both their source and receiving contexts. As such, we present findings from a study examining South–South intra-regional medical travellers' motivations, preparations and practices to better understand the social, economic and political situations that condition them and their effects on the destinations that receive them. Our study of Indonesian medical travellers pursuing health care in Malaysia draws on 35 semi-structured interviews with Indonesian patients, their companions, medical staff and agents in both countries. From this, we suggest that South–South medical travellers' diverse socio-economic conditions shape decision-making and spending behaviour relative to treatment, accommodation and transport choices as well as length of stay. We identify ways in which informal economies and social care networks sustain the formal medical travel industry. Finally, we observe how medical travel increasingly serves as a means through which chronic and everyday health needs are met through temporary, visa-free intra-regional movement.