###### Abstract  
Background: In recent decades, the size and passenger capacity of cruise/passenger ships has been associated with noticeable growth; in turn, this has created significant concerns regarding the adequacy of existing evacuation protocols during an \"abandon the ship\" situation (life threatening emergency). This study provides a systematic overview of related weaknesses and challenges, identifying critical factors that influence evacuation efficiency, and also proposes innovative/interdisciplinary solutions to address those challenges. It further emphasizes the growing complexity of cruise/passenger ship evacuations due to increased vessel size/heavy density of human population, as well as identifying the necessity of addressing both technical and human-centered elements to enhance safety and efficiency of those specific operations. **Methods:** Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, a comprehensive systematic literature search was conducted across academic databases, including Scopus, Science Direct, Google Scholar, and a limited number of academic journals that are heavily maritime-focused in their mission. Emphasis was placed on peer-reviewed articles and certain gray studies exploring the impacts of ship design, human behavior, group dynamics, and environmental conditions on evacuation outcomes. This review prioritized research incorporating advanced simulation models, crowd management solutions (applied in various disciplines, such as stadiums, airports, malls, and ships), real-world case studies, and established practices aligned with contemporary maritime safety standards. **Results:** The key findings identify several critical factors influencing the overall evacuation efficiency, including ship heeling angles, staircase configurations, and passenger (physical) characteristics (with their mobility capabilities and related demographics clearly standing out, among others). This effort underscores the pivotal role of group dynamics, including the influence of group size, familiarity among the group, and leader-following behaviors, in shaping evacuation outcomes. Advanced technological solutions, such as dynamic wayfinding systems, real-time monitoring, and behavior-based simulation models, emerged as essential tools for optimizing an evacuation process. Innovative strategies to mitigate identified challenges, such as phased evacuations, optimized muster station placements, and tailor made/strategic passenger cabin allocations to reduce congestion during an evacuation and enhance the overall evacuation flow, are also highlighted. **Conclusions:** Protecting people facing a life-threatening situation requires timely preparations. The need for a holistic evacuation strategy that effectively integrates specific ship design considerations and human factors management, along with inputs related to advanced information technology-related solutions, is the best way forward. At the same time, the importance of real-time adaptive management systems and interdisciplinary approaches to address the challenges of modern cruise/passenger ship evacuations clearly stands out. These findings provide a robust foundation for future research and practical applications, contributing to advancements in maritime safety and the development of efficient evacuation protocols for large-in-size cruise/passenger vessels.  
evacuation efficiency; passenger safety; cruise/passenger ship emergencies; emergency response; human factors; ship design