As mountain-based health and wellness tourism increases, destination competitiveness becomes ever fiercer. The pre-visit expectations and post-visit perceptions of tourists and the tourists’ behavioral intentions are related to the competitiveness of mountain-based health and wellness tourist destinations. Using structural equation modeling (SEM), we explored the factors that affect destination competitiveness and its relationships with tourism satisfaction and tourists’ behavioral intentions to return to and to recommend the location to others. We used a questionnaire for data collection from 550 tourists who visited a mountain-based health and wellness tourist destination in Panzhihua, China. The results suggested that there is an indirect positive correlation between tourists’ satisfaction and destination competitiveness, as well as a direct positive correlation between behavioral intentions and destination competitiveness, illustrating that tourist behavioral intentions can be an important factor in destination competitiveness. In the case of Panzhihua, the tourist source market in China has provided a competitive edge to this city. In addition, considering the environment’s capacity, developing an intention to return in tourists is important for tourism marketing in view of the increasing mountain-based health and wellness tourism competitiveness and concerns about sustainability.