There are plenty of alternatives.
LaTeX is merely a TeX macro package. There are others, such as ConTeXt. Also, if you hate the pick-a-package mentality, there are LaTeX packages that attempt to do it all in one package--Memoir is one.
You can elect to opt out of fancy layers on top of TeX and go with Extended Plain TeX or even just writing in plain TeX, which apparently Knuth did.
Don't like TeX at all? Try roff (or, more realistically these days, groff.) There is a package of roff macros called Mom, which now comes with groff.
In my experience roff is a better UNIX citizen than Tex & Co. I can put roff in a pipeline and it will do what I expect. TeX programs generally do not like to be run in this fashion. Perhaps as a consequence, it seems roff is hard to find outside of UNIX (roff is sort of a UNIX artifact) while TeX and friends run on Windows. I have slapped together a few utilities (I call one "latexstream") so that I can use LaTeX from a shell prompt without dealing with a bunch of temporary files scattered everywhere.
My needs are somewhat simple: I have a system that prints recipes and grocery lists. Nothing beats paper for a task like this. (I see some people using iPads in the kitchen. Forget that. I'm not taking greasy fingers to an expensive tablet.) Generally I am not happy using LaTeX for this. I actually do not want to separate content and presentation. I don't like having to muck around with packages to get what I want. And I don't like dealing with huge TeX distributions when I just need a few things.
But every time I look into all the alternatives I outlined above, I wind up sighing and sticking with LaTeX. None of these alternatives have the community that LaTeX has. I can do relatively simple things in LaTeX (like columns done in particular ways) that would require me to write a lot of code in plain TeX or in roff. Yes, TeX distributions are large, but I am now figuring out how to pare them down to just what I need. (Even though TeX Live suggests you install the whole thing. That's gigabytes. I'm on a smallish SSD. No thanks.)
So folks definitely have come up with alternatives to LaTeX. But if most folks are like me, I imagine they look at these alternatives and conclude that LaTeX with a gazillion packages works well enough.
[edit] forgot yet another alternative: Apache FOP, which uses XML. Some Docbook tool chains use it. IMO the output from those never look as good as the tool chains that ultimately use TeX.