This chapter explores the role of tourism within regional specialization strategies, emphasizing its possible impacts on competitiveness, economic growth and resilience. Tourism's integration with diverse economic activities—with different levels of relatedness—and its capacity to shape innovation and specialization processes are critically examined. The chapter discusses the formation of tourism clusters, highlighting their potential to enhance regional competitiveness while also identifying their limitations in fostering technological innovation. The relationship between tourism and economic growth is analyzed through the tourism-led growth hypothesis, considering both short- and long-term impacts. Additionally, the chapter addresses the vulnerability of tourism to external shocks and its implications for socio-economic resilience. Drawing on smart specialization frameworks and considering the path-dependent evolution of regional economies, the chapter concludes that tourism’s contribution to sustainable regional development depends on its ability to integrate knowledge-based services, enhance productivity and align with broader economic structures.