Altitude in Cusco: how to prepare

Plan the route before the packing list

Cusco sits at 11,200 ft (3,400 m). Time to acclimatize matters at this elevation, including for fit travelers. The CDC recommends a gradual ascent. CDC Yellow Book.

Our featured itineraries transfer from Cusco airport to the lower Sacred Valley first, as a planning recommendation rather than a rule for every trip. Signature Peru includes two nights there and Peru in Depth includes three; the shorter Essential Peru includes one. We then visit Machu Picchu before returning to Cusco. The Sacred Valley is about 9,000 ft (2,750 m), and Machu Picchu is about 7,970 ft (2,430 m). We keep the first days gentle and adjust the plan promptly if you feel unwell.

Tell us about your itinerary priorities before booking a high-altitude excursion. A day left open in Cusco is useful space: you can choose an activity, ask for a lighter day or simply rest without losing a prearranged highlight.

Speak to a clinician before you travel

Share your route, overnight elevations, medical conditions, medicines and any past altitude problems with a qualified clinician. Ask whether your plans need adapting and whether any prescription prevention is appropriate for you. Medication does not replace a gradual ascent. NaTHNaC altitude guidance.

We provide the route and overnight elevations for your clinician, who can recommend any medication appropriate for you. If you need a specific arrangement, discuss it with us before travel so we can check what can actually be provided.

Keep the first days gentle

The CDC advises only mild exercise during the first 48 hours at altitude and avoiding alcohol for that period. Save strenuous activities for later in the journey. CDC preparation advice.

In practical itinerary terms, that means leaving time after the airport transfer, eating at your own pace and keeping the first evening simple. Let your guide know how you feel. If you feel unwell, tell your guide and take a lighter day.

Drink regularly to stay hydrated and tell your guide about any symptoms. NHS altitude-sickness advice.

Know when to stop and seek help

Headache, nausea, dizziness, unusual tiredness, loss of appetite and poor sleep can occur with altitude sickness. Tell your guide or travel companion promptly. Do not go higher until symptoms have resolved. If symptoms worsen or do not improve after a day, seek help and descend if possible. NHS symptoms and action.

Confusion, difficulty with balance or walking, and breathlessness at rest are urgent warning signs. Get medical help immediately and arrange descent; do not wait for the next scheduled transfer. NHS urgent warning signs.

Our team can help arrange assistance. Our hotels and vehicles have oxygen available, and we work with a partner clinic in Cusco. Urgent symptoms need immediate medical attention and descent. Tell us as soon as there is a concern so the team can respond to the situation.

Treat higher excursions as optional

We schedule Rainbow Mountain later in the journey, after time to acclimatize. We discuss it before travel and reassess the plan based on how you feel and the conditions. Peru in Depth’s two open Cusco days give you the most space to make that decision.

Check that your insurance covers your planned activities, maximum altitude, emergency care and any rescue or evacuation that may be needed. Ask your insurer to confirm the cover for your specific itinerary. NaTHNaC travel-insurance advice.

A good trip can change shape. Choosing a city walk or time at your hotel instead of a mountain day is a sensible planning option. The aim is a journey you can enjoy, with timely help when you need it.