Taisuke Kanou is your average 16-year-old student. He has two close friends, Hirose and Megumi. Hirose has trouble with bullies, but Taisuke is always there to defend him, even though he just winds up getting beaten instead of Hirose. During class one day, Taisuke is hit by something unworldly and for that split second, he sees a vision of the universe. As he's walking home from school, he sees a girl fall and die in front of him, but his first thought is jealousy. He later finds out that the strange sensation that hit him is spreading throughout Japan. Those who are struck by it either commit suicide or "evolve," but the comrades that evolve usually have dark intentions for the rest of the world.

An anime adaptation was planned for Alive: Saishuu Shinkateki Shounen and was to be produced by anime studio Gonzo, but the production was canceled in 2010 when the studio was delisted from the Tokyo Stock Exchange.

The series was published digitally in English as Alive: The Final Evolution by Kodansha Comics USA from July 26, 2016, to August 29, 2017. Prior to this, Del Rey Manga had released eight printed volumes from July 31, 2007, to November 24, 2009, before publication was discontinued. The manga was also published in Italian by GP Manga from September 20, 2009, to July 24, 2011.