Cruise tourism generates an estimated $18 billion a year in passenger expenditure and has been the fastest growing sector of the travel industry for the past twenty years with an average annual growth rate of passengers of 7.4%. It has increased at almost twice the rate of growth of tourism overall and this growth is expected to continue in the future. The North American cruise industry is the dominant in this market with 12 million of passengers embarked in the US ports. The Caribbean region, continue being the most preferred cruise destination; according to FCCA statistics, accounting for 41.02% of all itineraries. The cruise passenger arrivals in the Caribbean region increased from 3 million in 1980 to more than 25 million in 2007. Cruise tourism can provide economic benefits to a local economy but the impacts of this activity are not well understood and have been neglected in the literature. In this paper the social, cultural, political economic and environmental impacts of cruise tourism are estimated. We describe the evolution of the cruise tourism industry and we review the experiences of different tourism cruise destinations. We present data to analyze and compare the performance of the main cruise destinations and cruise lines. We also describe different activities associated to the cruise ship industry to identify costs and benefits for the actors of the local economies. A case study is used to illustrate cost and benefits and the different impacts of cruises. This study aims to provide a critical viewpoint of how tourism destinations are transformed by the arrival of an increasing number of cruises.