What are the alternatives to annual performance appraisals?

The realistic alternatives are continuous feedback, quarterly goal or OKR reviews, 360-degree cycles, and hybrids of all three. Few companies drop the formal review entirely; what changes is that it becomes a summary of conversations that already happened rather than the only conversation of the year. The practical test is whether anything in the review surprises the employee. If it does, the problem is the feedback rhythm, not the appraisal form.