The issue of tourist destination management has been widely reflected in scientific literature. However, transnational destinations, i.e. those that are located on the territory of several countries, have not been given enough attention. The development of transnational destinations can occur provided there is close cooperation among key stakeholders. In the Baltic Sea Region (BSR) conditions for effective cooperation were created at the end of the 20th century when integration processes intensified. Currently, the BSR is the first macro-region of the European Union to implement a transnational strategy, in which tourism is recognised as a development priority. Creating an effective tourist destination management system has become a key challenge in this process. This article aims to identify and critically analyse the concept of transnational tourist destination management. Another goal is to identify the changing determinants of tourism management in the BSR and to explore relations between key stakeholders. To this end, we conducted a review of literature on destination management. We carried out a critical analysis of secondary sources (documents, information materials, the Internet resources) and supplemented the review with our insights from participatory observation. We also obtained additional information from interviews. Three models of destination management were identified: marketing-oriented, planning-oriented, and governance-oriented. Our research shows that the evolution of destination management is characterised by a gradual increase in the participation of public entities. This is related to the marginalisation of the tourism industry, which resulted in a systematic decrease in state funding for maintaining destination management structures. Acquiring the European Union funds from the European Territorial Cooperation Programs has become a partial but not entirely effective solution to this problem.