Straddle-type monorail systems offer advantages like small turning radiuses and rapid construction, but their unique guideway beams lack bridge deck space for evacuation walkways, presenting inherent safety constraints during elevated emergencies. While standards like NFPA 130 allow alternative measures like train-to-train rescue, their implicit assumptions regarding safe havens and rescue access remain debatable for elevated monorails. This qualitative study examines evacuation strategies and design limitations for stalled elevated monorails through comparative case studies of the Tokyo Monorail, Okinawa Urban Monorail, Chongqing Rail Transit Lines 2, São Paulo Line 15, and Bangkok Pink Line. These systems are analyzed based on walkway provision, operational rescue, external accessibility, and environmental conditions. Findings reveal that existing monorails heavily rely on operation-oriented strategies dependent on remaining train functionality and external conditions. In contrast, facility-oriented strategies with continuous walkways enhance self-evacuation capability and minimize passenger strandings. Furthermore, current safety standards lack clear mandatory guidance for monorail-specific structures, creating regulatory ambiguity that hinders resilience and risk mitigation for low-probability, high-consequence life safety incidents. To address these gaps, this study establishes a comprehensive design evaluation framework integrating elevated height, station spacing, geography, operational rescue capability, and external accessibility. This framework serves as a reference for future monorail planning, risk assessment, and technical standard revisions.