Sapropelic muds have been used for centuries to treat various illnesses, but their effects and mechanisms are still under research. In this study the effects of Techirghiol sapropelic mud on tissue oxygenation in elderly patients diagnosed with neuromuscular disorders were investigated using spatial and spectral information provided by hyperspectral imaging technique. A group of 38 elderly patients with neuromuscular disorders for which they received mud therapy was studied. Sapropelic mud was applied to the lumbar region of each patient for 30 min, directly on the skin in a thick layer, while a symmetrical area of 15 × 10 cm in the same region was covered with a medical patch to serve as the control area. The mud is typically heated to a temperature of 40–45 °C before application. Hyperspectral images were taken before, after the first day of therapy, and at day seven. Oxyhemoglobin and deoxyhemoglobin concentrations and oxygen saturation values were calculated from the hyperspectral images and compared to control areas. The results revealed that, in the treated area, the mean oxyhemoglobin concentration increased with + 0.2127 ± 0.1096 mol cm∕L, while deoxyhemoglobin concentration decreased by -0.0509 ± 0.0558 mol cm∕L. Local tissue oxygen saturation raised to over 98% in all patients. Lesser improvements were recorded for the control areas: oxyhemoglobin increased with + 0.1673 ± 0.1059 mol cm∕L, and deoxyhemoglobin decreased with − 0.0525 ± 0.0578 mol cm∕L. A good level of agreement was found between values of oxygen saturation measured with hyperspectral imaging method and the classical pulse oximetry method. Thus, improvement in local circulation was demonstrated after mud therapy. In conclusion, therapy with Techirghiol sapropelic mud improved local tissue oxygenation, hyperspectral imaging being a reliable and non-invasive tool for monitoring these changes.