Alternative design and arrangements (AD & A) represent both a distinctive feature and a challenge in cruise ship design, and constitute one of the core technologies that must be urgently mastered to achieve independent design of cruise ships in China. Four typical application scenarios of AD & A for cruise ship fire safety, namely super-large main vertical zones, lifts without independent machine rooms, non-steel structural materials, and super-large fire doors, are first analyzed. The process of AD & A for fire safety is then summarized and refined, providing a concise overview of the main tasks involved in the four stages: preparation, preliminary qualitative analysis, quantitative analysis, and final scheme implementation. Finally, the key technologies and research progress in AD & A for cruise ship fire safety are elaborated in detail from three aspects: fire hazard identification, life safety performance criteria, and rapid approval of AD & A schemes. Meanwhile, several suggestions on the foundational works related to AD & A are offered.