Cruise tourism is the fastest growing segment of leisure tourism. With its growth has come concern about the impact of cruise tourism on coastal and marine environments, local economies, and on the sociocultural nature of port communities. These three areas are key elements in analyses focused on responsible tourism, and form a critical base from which to consider strategies to ensure the sustainable development of cruise tourism. The goal of this article is to illustrate how a responsible tourism lens measures the impact of cruise tourism and, with its focus on the perceptions of host communities, more effectively addresses grassroots concerns. Case examples are used to identify and describe challenges faced by governments, communities, and the cruise industry. Analysis of these issues and challenges gives direction for how cruise tourism can grow in ways that are both sustainable and responsible.