There are four major factors contributing to surf therapy: 1. Aquatic Environment (Water Physical Properties) – Important in the functional rehabilitation (balance, strength, flexibility); stimulating and relaxing effect; absence of gravity, improves mobility; improves cardio-respiratory capacity; integral muscular work; pleasure. 2. Environment – Individual Interaction (Sensory Integration in an environment rich in stimuli): Environmental rich in sensory stimuli (water, sand, seaweed, rocks, aquatic fauna); Awareness for the environment protection; Help finding healthier ways of interaction with the surrounding world; 3. Individual – Coach / Therapist Interaction (works concepts like expression of feelings and emotions): The trust relationship between teacher / therapist allows the individual to explore their intra-personal conflicts and find solutions; the expression of emotions; look/gaze, physical presence, touch, movement; sharing feelings; working the intrapersonal and interpersonal concept; improved self-esteem. 4. Group Interaction (works concepts such as socialization, Leadership, Inter- help) – Contribute in a playful way, to the motivation of a group; establishing a suitable climate for interpersonal interaction; develops social skills; develops concepts of leadership, mutual respect, and mutual help. In short, surfing can and should be seen as an added value in the prevention and treatment of many pathological conditions, contributing to social inclusion, avoidance of a sedentary lifestyle and stress, improvement of self-esteem and encourage teamwork as well as to stimulate protection of the environment and quality of life.