This paper deals with a comparative study between Brazil, China and Philippines on services marketing. By focusing on culture, standardization/adaptation, trust and network, attempt is made to illustrate how impact of service characteristics can be handled to smooth marketing of health care services internationally. Data has been collected through face-to-face semi-structured interviews with 21 respondents from Brazil, China, Philippines and Sweden. The result shows that culture has much effect on the operations of Elekta Philippines and China while Brazilian establishment is run by following general marketing practices. Standardization has been common regarding treatment and service quality but some adaptation has taken place in Philippines to treat new diseases not included in the Gamma knife tradition. Trust is found necessary in all the cases but has been built in different ways. In China, guanxi has been used to develop informal relationships with the customers to ensure trust. Trust in Philippines is developed by recruiting relatives and friends and relying on experience in work with old Gamma knife facility. In Brazil, long-term relationships with the customers have been stressed and are built on understanding, business facts, competence and customers' access to Elekta reference centers.