From the man page man sshd
PermitRootLogin
Specifies whether root can log in using ssh(1). The argument
must be yes, prohibit-password, without-password,
forced-commands-only, or no. The default is prohibit-password.
If this option is set to prohibit-password or without-password,
password and keyboard-interactive authentication are disabled for
root.
If this option is set to forced-commands-only, root login with
public key authentication will be allowed, but only if the
command option has been specified (which may be useful for taking
remote backups even if root login is normally not allowed). All
other authentication methods are disabled for root.
So, "without-password" allows root to log in via any method EXCEPT password authentication. This can include ssh keys and kerberos.
IMO this is a secure option.
See also What does 'without password' mean in sshd_config file?