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This paper aims to summarize publications related to new generation of tube geommetry, thermal performance, and flow characteristics in different cross-sectional manners, and the effect of crucial parameters on thermal-hydraulic performance. An alternating cross-sectional tube has an enhanced vorticity without installing vortex generator devices. Multi-longitudinal vortices are induced along the length of the tube: this makes a significant enhancement in the thermal performance of the tube. Many published papers have focused on the heat transfer and flow characteristics of the alternating cross-section tubes in various configurations in the past two decades. Although the cross-sections had different shapes, the flow behaviors and vortex generation were similar. The geometric parameters, like aspect ratio, pitch length, transition length, alternating angle, phase-shifting, and the total length, influenced the thermal-hydraulic performance of the alternating cross-section tube. The flow characteristics in an annular region differed between the alternating cross-section tube as internal and external tubes. Moreover, some researchers proposed the Nu and f correlations for the practical design of heat exchangers. Finally, future research works and improvement guidelines for alternating cross-section tubes are revealed.