In response to the pressing need for transportation decarbonization, this paper examines the often overlooked domain of inland waterway transport and seeks to answer which alternative fuel or power source is the most promising for that sector. As the shipping industry significantly contributes to global carbon emissions, it has been shifting towards alternative fuels and decarbonization measures in the effort to reduce them, whereas the inland waterways, operating predominantly on diesel engines, have not achieved equivalent substantial progress. Employing a systematic literature review and regional analysis, this study identifies notable trends. LNG initially emerged as a favored alternative fuel, but recent studies emphasize a shift towards “greener” solutions like batteries and hydrogen. Europe and Asia lead in these developments. This investigation uncovers critical gaps in research and development, particularly in the Northern European countries that have extensive inland waterway networks. It also calls for future studies to explore the performance of vessels that have adopted LNG compared to other emerging alternatives and emphasizes the importance of considering the time lag between technology development and research publication.