Background: COVID-19 and its associated restrictions called for innovations in higher education teaching and learning space with many universities resorting to online teaching and alternative assessments. However, little has been done to understand the academic integrity implications in alternative online and non-invigilated assessments. Aim: This study explored the perceptions of higher education students regarding academic integrity in alternative assessments. Methods: Cross-sectional mixed method design following the parallel convergent approach was utilised in this study. A convenience sample of 380 undergraduate and postgraduate nursing and social science students completed an online survey on academic integrity behaviours associated with alternative assessments. Results: High risk (31.7%) of academic misconduct was perceived among young people (18-24 years old). Collusion was common among nursing students (24.5%) and cheating likely to occur in assessments with longer duration--between 2 and 4 hours (18.8%) and between 1 and 2 weeks (46%). Qualitative data resulted in 274 findings and three themes--(i) impossible to cheat; (ii) easy to cheat and (iii) understanding the consequence of cheating. Suggestions for preserving academic integrity in alternative assessments were also made from the qualitative data. Conclusion: Like other forms of traditional assessments, alternative assessments have increased risk of breach of academic integrity; however, with the right strategies, they could serve as effective means of assessing learning outcomes.