World heritage status ratifies the enduring significance of a specific place for all of humanity. Inscription on the UNESCO World Heritage register not only formally recognises the local, national and international importance of place, but equally creates a range of externalities that are often construed to be positive and hence desirable. Foremost amongst these are the economic benefits purported to flow from tourism. Within the wider pantheon of tourism, world heritage tourism is a rapidly growing niche market. The logic follows that the economic benefits generated through world heritage tourism can, in part, be invested into the development and management of the site so as to preserve it for future generations to enjoy. However, the reality is much more complex. World Heritage tourism is in fact a double-edged sword. With increased visitations come the risk of over-crowding, an erosion of the very features and amenities that underpin the designation and possibly the commodification of the site itself. Consequently, the careful management of world heritage sites is essential to ensure that the impacts of world heritage tourism are mitigated. This chapter critically engages with these challenges, drawing upon a case study of the World Heritage core of George Town, Penang.