Growing maritime commercial activities in the High North increase the possibility of unwanted incidents. The vulnerability related to human safety and environment and a challenging context, call for a strengthening of the maritime preparedness system, and cross-boundary and cross-institutional collaboration. In this paper, we look into the different stressors and risk factors of the sea regions in the High North. We elaborate on emergencies where integrated operations such as mass evacuation, oil spill recovery and salvage are needed. Coordination of such operations is a challenging task, where several institutions and management levels are included. Host nation support from neighboring countries may be in demand. Experiences from the accident with the cruise ship “Maxim Gorkiy” in the ice south-west of Svalbard are highlighted together with the experiences from large-scale exercises in the High North. We illuminate the capabilities needed, and the training of key personnel responsible for coordinating such operations.