Adobe Acrobat DC, PDF24 Creator, PDF-XChange Editor, Master PDF Editor, PDFsam, Foxit PhantomPDF, Nitro PDF Pro, Sejda, PDFescape, Skim, PDF-Shuffler, PDF Expert, PDFtk, AlterPDF, PDF Arranger, PDFTK Builder, PDF Chain, PDF-Tools, Qoppa PDF Studio, PDF Shaper, Wide Angle PDF Converter, jPdf Tweak, PDF Mix Tool, Junko, FlexiPDF, SoftMaker FreePDF, Best PDF Tools, Orion PDF Author, PDF Studio by Bullzip, krop by Armin Straub are some alternatives to PDF4QT.