Ship collisions remain a critical challenge for maritime safety, structural integrity, and environmental protection, particularly as modern vessels increase in size, operational speed, and structural complexity. Numerous experimental, numerical, and analytical methods have been developed to evaluate collision-induced damage and associated risks. However, existing studies on ship collision damage assessment often lack systematic comparison, methodological integration, and sufficient technical depth. This paper presents a comprehensive and critical review of current approaches to structural damage assessment in ship collisions, encompassing experimental testing (quasi-static and dynamic impact), numerical simulation, and analytical modelling. The methods are examined with respect to structural configuration, collision scenarios, modelling assumptions, computational demand, and practical applicability. Key limitations identified in the literature include reduced physical realism, limited system adaptability, computational constraints, high-strain-rate fracture uncertainty, scarcity of validated large-scale data, and the gap between laboratory-scale experiments and full-scale structural behaviour. To address these challenges, a multi-tiered assessment framework is proposed. Analytical methods are positioned for preliminary evaluation and rapid screening, numerical simulations for predictive impact analysis and detailed structural response, and experimental approaches for validation and mechanistic insight. This framework aims to guide researchers, ship designers, and safety analysts in selecting appropriate methodologies and advancing future developments in ship collision damage assessment. © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.