The mountains between Virginia and West Virginia once had many spring resorts that catered to the medical and recreational needs of people who lived in the lowlands along the Atlantic coast. Some were established as early as the mid-1700s, and a few remain today. The springs range southwestward from Berkeley Springs in the Eastern Panhandle to Mercer Healing Springs near Princeton, with White Sulphur Springs and (in Virginia) Warm Springs being the most prominent.

The resorts were built around mineral or thermal springs. The mineral springs contained various dissolved salts; the thermal springs had temperatures varying from 62 to 106 degrees Fahrenheit. Most of the springs in the Blue Ridge region and along the Allegheny Front issue from Oriskany sandstone and Helderberg limestone (both of the Devonian geologic age). Rainwater enters a permeable formation along an outcrop at a high elevation and permeates down to an outcrop at a lower elevation. The temperature of the water is normally the same as the earth's temperature. Thermal spring water comes from deep in the earth, where temperatures are higher.

The classification of the waters may be broken down into six categories. Saline waters have dissolved salts of calcium, magnesium, and sodium. Sulfur waters contain hydrogen sulfide and have a "rotten egg" smell. Chalybeate waters contain iron. There are also some alkaline, calcic (lime), and thermal waters.

At a time when medical science could do little for patients, it was believed that the spring waters could cure common diseases. Lured by advertising, patients came to drink the water, to bathe in it, or to rub themselves with it. The therapeutic effect of the water may be questioned, but the overall experience may well have been healthful. Certainly the elevation of the mountain resorts and the clean air helped many, and the diseases common to low-lying areas were not found in the mountains.

A number of factors contributed to the demise of the spring resorts. The destruction that occurred during the Civil War and the changing social system in the South after the war were contributing factors, as were better medical treatment and newly discovered cures for diseases. The coming of the automobile in the early 1900s changed the fabric of American life, including travel and recreation habits. Many resorts suffered disastrous fires. Some never reopened after the hotel or main buildings burned down, and many never regained their former glory. It appears that arson was the cause of some fires, perhaps reflecting fragile financial health.

The old resorts have found various uses. Examples include Minnehaha Springs in Pocahontas County, now a boys' summer camp; Sweet Springs in Monroe County, until recently a state home for the aged; Salt Sulphur Springs in Monroe County, now a private residence. Barger Springs in Summers County is a community of private summer homes or camps, and Mercer Healing Springs is a private farm. Little remains at Red Sulphur Springs in Monroe County and Blue Sulphur Springs in Greenbrier. Although, renovation of the historic pavilion at Blue Sulphur Springs was completed in 2023.

Today only a few of the resorts are still in business. The most famous of these is the world-renowned Greenbrier at White Sulphur Springs, in Greenbrier County. The others are the Capon Springs Resort in Hampshire County, the Berkeley Springs State Park in Morgan County, and Pence Springs in Summers County. Lee Sulphur Spring in Hardy County remains open to the public at Lost River State Park.