In order to maintain the distinctive character of a wine region or destination appellation, a number of important factors impacting wine tourism destination sites should be considered. This chapter examines some of these impacts within the framework of a model of wine region development and discusses the need for the implementation of sustainable wine tourism development practices in a destinational context. It also discusses the issues of wine tourism sustainability by applying Butler's destination evolution model to the development of a wine region, and using a case study of the Napa Valley. At a regional or destination level, a number of benefits may accrue from the development of wine tourism. Sustainable tourism development should entail a long-term perspective for the use of resources in tourism production. Providing a sustainable wine tourism product depends upon the survival of the local wine industry.