The aim of this paper is to critically assess the methods used for the evaluation of wave-induced loads on ships examining analytical, numerical and experimental approaches. The paper focuses on conventional ocean going vessels and loads originating from steady state and transient excitations, namely slamming, sloshing and green water, for the latter, and including extreme or rogue waves, as well as the more occasional loads following damage. The advantages and disadvantages of the relatively simpler potential flow approaches against the more time consuming CFD methods are discussed with reference to accuracy, modelling nonlinear effects, ease of modelling and of coupling with structural assessment procedures, suitability for long term response prediction and suitability for integration within design and operational decision making. The paper also assesses the uncertainties involved in predicting wave-induced loads and the probabilistic approaches used for the evaluation of long term response and fatigue analysis. The current design practice is reviewed and the role of numerical prediction methods within the classification framework and goal based design approach discussed. Finally the suitability of current developments in prediction methods to meet the needs of the industry and future challenges is assessed.