Cruise ships

Are cruise ships safe?

For most passengers, yes. Large cruise ships seldom sink, burn or run aground, and on a typical week-long cruise the chance of dying in an accident is roughly one in a million, about 1 micromortMicromortA one-in-a-million chance of death. It lets you compare the risk of very different activities on one scale.More in the glossary. That is about the risk of a 100-mile drive in the US, or six or seven commercial flights.

The catch is everything that is not an accident. People fall on wet decks and stairs, stomach bugs spread fast through 4,000 passengers sharing buffets, and a heart attack on a sea day happens far from a hospital. A cruise is safe; being seriously ill on one is not ideal.

How did we estimate the death risk?

No authority publishes accidental deaths per cruise. We built the estimate from the parts that are counted.

• Passengers. The cruise industry body CLIA counted 37.2 million ocean cruise passengers in 2025 and 34.6 million in 2024.
• Overboard. Cruise Junkie, a long-running list compiled by Ross Klein from news reports, counted 25 people overboard from cruise ships and ferries in 2023, 19 in 2024 and 13 in 2025, crew included and some rescued. Even if every one were a cruise passenger who died, that is under 1 per million passengers.
• Other accidents. Falls, pool drownings and shore excursion crashes add to this, and so do the rare disasters, such as the Costa Concordia grounding off Italy in 2012.

Put together, about 1 micromortMicromortA one-in-a-million chance of death. It lets you compare the risk of very different activities on one scale.More in the glossary per cruise is a fair central figure, and it could be lower. Deaths from natural causes, mostly heart disease in older passengers, happen on every large ship but would have happened at home too. We leave them out. Our confidence in this number is low because no one collects the full picture.

Falls are the most common serious injury

A three-year study on one ship, published in International Maritime Health, recorded 0.8 injuries per 1,000 passenger-days. One in eight was serious, meaning a hospital stay ashore or more than two weeks to recover. Slips, trips and falls caused 45% of injuries on board and 69% ashore. Cabins and bathrooms were the most common places to get hurt on the ship; streets and tour buses ashore.

The injured were old: the median age was 72. A study at a US trauma centre found the same pattern. Of 67 cruise passengers admitted, 79% had fallen at ground level, 70% were 65 or over, and more than half had broken a femur.

Norovirus and other illness

The CDC's Vessel Sanitation Program posts an outbreak whenever 3% or more of passengers or crew on a ship sailing to US ports report stomach symptoms. It listed 14 outbreaks in 2023, 18 in 2024 and 23 in 2025, most of them norovirus. Outbreaks are unpleasant and can spoil a trip, but they are rarely dangerous for healthy adults. Older people and anyone with weak immunity should take dehydration seriously.

Respiratory infections spread on ships too. In early 2020, the Diamond Princess quarantine off Yokohama became one of the first large COVID-19 outbreaks outside China.

Far from help

Every large ship has a doctor and nurses, and many can stabilise a heart attack or a broken hip. What they cannot do is surgery or intensive care. On a sea day, a medical evacuation means a helicopter at the edge of its range or a diversion to the nearest port, which may be in a country with limited hospitals. Someone who goes overboard at night, unseen, is rarely found alive.

How to stay safe on a cruise

1. Never sit on, lean over or climb a railing, and do not let children climb balcony furniture.
2. Drink with some care. Alcohol features in many overboard cases and falls.
3. Wear shoes with grip on pool decks and outside stairs, and use handrails at sea.
4. Wash your hands with soap before every meal. Alcohol gel is weaker against norovirus.
5. Go to the muster drill and know your muster station.
6. Buy travel insurance that covers medical evacuation, and carry enough of any regular medicines for delays.
7. Pick shore excursions carefully. Ashore is where many injuries happen; choose licensed operators with life jackets on boats and seat belts on buses.

How we scored it

Fatality risk (86) is low but not as low as a train or flight per trip. Injury risk (78) reflects falls, mainly among older passengers. Controllability (70) is good because many overboard deaths and falls follow avoidable choices. Rescue and environment (55) is the weak point: on sea days you are far from a hospital. Our open water swimming page covers what happens to people in the sea.