The issue of measuring and evaluating the enterprise performance and efficiency remains an open question, as identification and management of the financial health still represent a prerequisite for improving strategic management decision-making processes. In this regard, the aim of paper was to evaluate the performance and efficiency of the Slovak medical spa sector for the period 2012- 2017, to examine the possible interconnection of these two dimensions of entrepreneurial activity as well as to emphasize the importance of financial situation assessment in order to develop management control system of enterprises. The results of spa sector performance measured by the Economic Value Added and efficiency quantified on the basis of linear programming using the Simplex Method revealed significant shortcomings, since both dimensions were evaluated as average and inadequately profitable for shareholders. Detailed monitoring of the development and identifying the current state of performance and efficiency of the analysed spa companies is a fundamental starting point for financial managers within the implementation of new tools, techniques and systems for their continuous improvement. Thus, performance efficiency management is essential to achieve sustainable success, goals, plans, strategies and competitive position of enterprises.