While there is a growing consciousness about the importance of visually pleasing environments in healthcare design, little is known about the key underlying mechanisms that enable aesthetics to play an instrumental role in the caregiving process. Hence it is often one of the first items to be value engineered. Aesthetics has (rightfully) been provided preferential consideration in such pleasure settings such as museums and recreational facilities; but in healthcare settings it is often considered expendable. Should it be? In this paper the authors share evidence that visual stimuli undergo an aesthetic evaluation process in the human brain by default, even when not prompted; that responses to visual stimuli may be immediate and emotional; and that aesthetics can be a source of pleasure, a fundamental perceptual reward that can help mitigate the stress of a healthcare environment. The authors also provide examples of studies that address the role of specific visual elements and visual principles in aesthetic evaluations and emotional responses. Finally, they discuss the implications of these findings for the design of art and architecture in healthcare.