In this series of papers we have presented the results of a spectroscopic survey of luminous and variable stars in the nearby spirals M31 and M33. In this paper, we present spectroscopy of 132 additional luminous stars, variables, and emission line objects. Most of the stars have emission line spectra, including LBVs and candidate LBVs, Fe II emission line stars and the B[e] supergiants, and the warm hypergiants. Many of these objects are spectroscopically similar and are often confused with each other. With this large spectroscopic data set including various types of emission line stars, we examine their similarities and differences and propose the following criteria that can be used to help distinguish these stars in future work: 1. The B[e] supergiants have emission lines of [O I] and [Fe II] in their spectra. Most of the spectroscopically confirmed sgB[e] stars also have warm circumstellar dust in their SEDs. 2. Confirmed LBVs do not have the [O I] emission lines in their spectra. Some LBVs have [Fe II] emission lines, but not all. Their SEDS shows free-free emission in the near-infrared but no evidence for warm dust. Their most important and defining characteristic is the S Dor-type variability. 3. The warm hypergiants spectroscopically resemble both the LBVs in their eruption or dense wind state and the B[e] supergiants. However, they are very dusty. Some have [Fe II] and [O I] emission in their spectra like the sgB[e] stars, but can be distinguished by their absorption line spectra characteristic of A and F-type supergiants. In contrast, the B[e] supergiant spectra have strong continua and few if any apparent absorption lines.
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