How to beat altitude in Cusco

Cusco sits at about 3,400 metres (verify). Your lungs will notice before you do. Most visitors feel something in the first 24 hours: a dull headache, a racing heart on the stairs, a night of patchy sleep. Very fit people get it too. Fitness and altitude tolerance are different things.

1. Sleep lower first

The single most useful thing we do is change the order. Instead of flying into Cusco and sleeping there, we drive you straight down to the Sacred Valley, roughly 2,800–2,900 metres (verify). It's about 500 metres lower than the city and a far gentler first night. Two nights there, then Machu Picchu (lower again, about 2,400 m), and then Cusco.

By the time you arrive in the city, your body has had four or five days to adjust.

2. Take day one seriously

On your first day above 2,500 metres:

• Walk slowly, especially uphill and on stairs.
• Skip the big hike, the late night and the third pisco sour.
• Eat light and drink plenty of water.
• Rest in the afternoon, even if you feel fine.

3. Climb in steps

Mountain guides talk about climb high, sleep low. If you're heading somewhere very high, like Rainbow Mountain (about 5,000 m) or the Salkantay Pass (about 4,600 m), do it at the end of your Andean days, never the start.

Our altitude page shows how each journey climbs, night by night. You can also build your own route and see where it gets steep.

4. Know the warning signs

Mild symptoms usually ease within a day or two. Tell your guide straight away if symptoms get worse, or if you notice confusion, breathlessness at rest, or difficulty walking in a straight line. The answer is usually to go lower, and our team can arrange that at any hour.

5. About coca tea and medication

Many hotels offer mate de coca on arrival. It's a traditional mild remedy and pleasant to drink, but it doesn't replace acclimatising. Some travellers take prescription medication for altitude; whether that's right for you is a conversation for your doctor, not for us.

The short version

Start lower, go slowly, drink water and leave the biggest climbs for later. Then Cusco is all yours.