Cave tourism attracts millions of tourists worldwide annually, generates significant economic impact to surrounding communities, and thus serves as an effective regional development strategy for many countries. Previous cave tourism research primarily examined tourists’ motivations and constraints, loyalty, and benefits sought. Still, research is limited on the evaluation of service quality (e.g., interpretation programs) that influence tourist experience. Such lack of understanding is detrimental to cave management (e.g., meeting tourist needs, resource optimization), with unknown effectiveness of programs/activities. Therefore, this study was conducted to evaluate tourist satisfaction and service quality of cave tours through the Importance-Performance Analysis (IPA). Surveys were collected among visitors at three public and private show caves in the Cave State of Missouri, from 2022-2023. In addition to advancing cave tourism scholarship, results of this study will help inform cave managers of program design and delivery, enhance tourist on-site experience and ultimately contributes to regional development.