Present paper investigates the factors contributing to the stress response of steel sandwich panel deck joints when applied into the hull girder of modern passenger vessel. The emphasis is put on the fatigue analysis, which is the critical design criterion in application of these structures to ships. Two types of joints are considered, i.e., a symmetrical and a nonsymmetrical prismatic joint with respect to the geometrical midplane of the sandwich panel. Stiffness properties are derived for the joints in order to enable the modeling of sandwich structures as part of the hull girder finite element model. The influence of sandwich joints to hull girder response is studied. Notch stress analysis is used for the fatigue strength estimation. The applicability of notch stress method for steel sandwich panels is validated with experiments. The investigation shows that the fatigue strength of steel sandwich panels does not depend only on local stress concentration factors at details, but also on the global stiffness of the structural hull girder system, the sandwich panels, and thus the joint response must be taken into account.