What Happens if You Fall Overboard on a Cruise Ship?

And how to avoid this nightmare scenario, according to experts.

M

ost cruise-goers board their ship without a care, ready for a week of sunning on the deck by day and watching a Broadway-quality show every night.

Yet, occasionally, cruises take a tragic turn. In October 2024, a woman died after falling overboard on a Royal Caribbean Taylor Swift-themed cruise. In December 2022, the Coast Guard found a man who had fallen off a Carnival Cruise; he was still alive after spending 20 hours treading water in shark-infested waters. These aren’t isolated incidents. The Cruise Line International Association (CILA) reported 212 “man overboard” incidents between 2009 and 2019. Less than half of those who went overboard survived.

Cruise ships are generally very safe, and most passengers disembark from their cruises with nothing worse than a sunburn. However, falling overboard is always a risk, and it’s important to be prepared in case you unexpectedly find yourself in the ocean or spot someone in distress.

We asked experts why people fall overboard and how to increase your chances of survival if you or a fellow passenger find their cruise has taken a turn for the worse. No matter the cause, travel security expert Frank Harrison of World Travel Protection recommends reporting anything that appears unsafe or anyone exhibiting unusual behavior to the crew so they can intervene before tragedy strikes.

The Most Common Ways People Fall Overboard

Alcohol and Drug Use

Many people take cruises to have a good time, but drinking too much or using illicit drugs is risky on a ship. “Alcohol is one of the primary factors in overboard incidents,” says Eric Wolk, a board-certified emergency medicine physician with a specialized focus in travel medicine and the founder of JetSet Meds. “It can impair judgment, balance, and spatial awareness.”

Popular all-you-can-drink packages also pose a risk. Carrie Pasquarello, who specializes in risk mitigation for tourism and is CEO at Global Secure Resources Inc., explains that many travelers “want to get their money’s worth” if they purchase one of these packages, which can lead to excessive drinking. The risk of falling overboard while drunk increases if you are alone or it is night, she adds. According to Pasquarello, passengers should always avoid drinking alcohol alone at night. She believes cruise lines should better communicate the risks of getting too drunk while at sea. If you plan on drinking during your cruise, Harrison recommends appointing a “sober observer” to help keep you safe.

Medications and Health Conditions

Many conditions may cause people to lose balance or become disoriented. Wolk explains that these can often contribute to a fall. If you have any of these conditions, exercise caution and always have someone with you while at sea.

Some medications pose a risk, including muscle relaxers and sleep aids. These drugs “increase the likelihood of a fall overboard,” so “take them with caution” on cruises, Wolk says. Moreover, people with certain medical conditions, including a history of seizures, fainting, dizziness, or heart conditions, need to be careful on ships, Wolk advises. Illness or dehydration can also pose a risk, Harrison adds.

Mental Health Conditions

When some people go overboard, mental health may play a role, Wolk says. In some cases, passengers intentionally jump off of ships into the ocean. While it’s hard to know exactly what motivates someone to jump, these incidents are usually presumed to be suicide.

Risky Behaviors and ‘Vacation Brain’

Engaging in risky behaviors such as “climbing on railings or attempting to retrieve items that have fallen over the edge, significantly increase the likelihood of accidents,” Wolk says.

Some passengers who go overboard may not fully realize the risks they are taking. Michelle Endo, who worked on cruise ships for three years and runs Wander Eat Write, says that during her three years working on cruise ships, she often saw passengers develop “vacation brain.”  Some guests “come onboard and seem to leave their brains at home, thinking that things somehow work differently at sea than back home on land.”

Endo says that passengers would probably never consider climbing “over the railing on the roof of a 12-story building to stand on the edge,” but they don’t think there’s any harm in doing so on a mega cruise ship for a photo or video.” She emphasizes that ship railings and other safety measures are in place to keep guests safe, but they lose their effectiveness if “those railings are climbed.”

Although Endo didn’t witness the accident, she was working on a ship in 2019 when a toddler fell out of her grandfather’s arms and died. Before the girl fell, her grandfather had lifted her over a railing and held her through a large, open window. A judge ruled that the cruise line was not responsible for the tragedy because he should have realized the risk he was taking. The grandfather was later charged with negligent homicide and pleaded guilty.

Ship Hazards

Unpredictable ship movements can happen at any time. “Ships can lurch unexpectedly due to waves” or high winds “which can unbalance passengers, particularly those near railings,” Wolk says. Slippery decks, broken safety equipment, sudden changes in direction, rain, and poor lighting can also lead to falling overboard.

To help passengers stay safe, Wolk emphasizes that they need to stay aware of their surroundings. “Remaining cautious, especially near railings or during rough weather, can prevent accidents,” he says.

Criminal Incidents

Although rare, Harrison says that occasionally, “passengers are pushed or subjected to violence that results in overboard accidents.” If other passengers are becoming rowdy or aggressive, it’s best to walk away, he advises.

What Should You Do if You Fall Overboard?

If you fall overboard, “surviving depends on quick thinking and specific strategies,” Wolk says. First, although it may be difficult not to panic, “staying calm is critical to conserving energy,” says Donald Bucolo, a cruise specialist with Eat Sleep Cruise who has received extensive safety training. “Panic can lead to exhaustion,” Wolk says, which can lead to being too tired to implement other crucial survival strategies.

Second, you should signal for help. Yelling loudly and waving your arms is the most effective way to get attention, Bucolo says. Once you start to get tired, Bucolo recommends placing one hand on your head while treading water to conserve energy. This is a distress signal commonly used by scuba divers who need assistance and is widely recognized as a call for help by those who spend a lot of time in or near the ocean. However, Wolk recommends shouting and waving again “if nearby vessels or lights are visible.”

Third, Bucolo recommends keeping your clothing on. Clothing “can help create buoyancy to help you stay afloat longer without using as much energy,” he says. It can also provide “thermal protection in colder waters,” he explains. If you are wearing a long-sleeve shirt or pants when you fall overboard, Bucolo recommends taking those off and filling the arms or legs with air by swinging them over your head and tying off the ends. This will create more buoyancy and help you conserve energy, he explains.

Wolk also suggests that you position yourself to float to conserve energy. “Lie back to keep your body buoyant, especially if you’re not a strong swimmer, ” he says. Finally, Bucolo recommends staying put. “Remaining near where you fell can increase the chances of a quicker rescue,” he explains.

What Should You Do if You See Someone Go Overboard?

When someone goes overboard, how quickly they can get help greatly impacts their chances of survival. However, instead of running for help, Endo explains that it’s essential to keep your eyes on the person who went overboard while pointing and following them with your finger, Endo says. Endo explains that this is essential because it’s very easy to lose track of where someone is in open water. She adds that people tend to underestimate how quickly cruise ships move.

While keeping your eye on the person in the water, Endo says you should get the attention of the nearest crew member or find another passenger to alert the crew. If possible, she suggests asking other bystanders to gather multiple life rings, which are found along all open decks, and “throw them in the direction of the person in the water while you continue to track and follow them with your finger.”

Wolk stresses that under no circumstances should other passengers jump into the water to try to perform a rescue themselves. Doing so will “complicate rescue efforts and endanger you as well. It’s best to leave the rescue to the trained crew,” he says.

What Will the Crew Do When Someone Goes Overboard?

Once the crew is alerted, they will spring into action. Endo says many ships have surveillance systems that will alert them when someone has gone overboard, even before a passenger reports the incident.

If that happens, the ship will sound an alarm and immediately record the GPS coordinates to help pinpoint where the person went overboard, Wolk says. The crew will also review security footage to see if they can refine the search area even more.

Rescue efforts will also start right away. “The ship will often deploy rescue teams “and notify nearby vessels and maritime authorities” that someone is in distress, Wolk explains.