Revealing the hidden realities of cruise vacations, this survey rings the alarm on cruise ship safety and outlines the risk to passengers of sexual assault, onboard crime and injury, and death from accidents at sea. Covering the industry’s dubious environmental performance and its impact on the efforts of governments to protect their marine habitats, this shocking investigation also exposes the truth about health risks and medical care onboard these floating cities, opening the door on the dark side of life below the passenger decks. Exploring the myths that cruise vacations are all-inclusive and that cruise tourism contributes billions of dollars to local economies, this account concludes by summarizing issues and challenges that must be faced by cruise passengers, port communities, and ship employees.