Travelling in Peru often means moving quickly from the coast to the Andes. Cusco lies at about 3,400 metres above sea level, while several trekking passes exceed 4,000 metres. Understanding altitude sickness before you arrive helps you plan a safer and more enjoyable journey.
What is altitude sickness?
Altitude sickness, commonly called soroche in Peru, can affect travellers who reach high elevation before their bodies have adapted to the reduced oxygen pressure. The mildest and most common form is acute mountain sickness (AMS). Physical fitness does not protect against it: even experienced athletes can be affected. Your previous response to a similar altitude and ascent rate is a more useful guide, although it cannot guarantee how you will feel on a future trip.
Common symptoms and warning signs
AMS usually involves a headache together with symptoms such as nausea, dizziness, unusual tiredness, reduced appetite or disturbed sleep. Do not continue ascending if symptoms are worsening. Severe breathlessness at rest, confusion, loss of coordination, extreme weakness or a persistent cough can indicate a medical emergency. Descend and seek urgent professional help.
Cusco, Machu Picchu and trekking altitude
- Lima: near sea level
- Machu Picchu: approximately 2,430 m
- Sacred Valley: generally lower than Cusco, with many towns around 2,800–3,000 m
- Cusco: approximately 3,400 m
- Classic Inca Trail: up to about 4,215 m at Dead Woman’s Pass
- Salkantay Trek: commonly up to about 4,630 m at Salkantay Pass
Machu Picchu itself is lower than Cusco, but many visitors arrive in Cusco first or combine the citadel with much higher Andean routes. An itinerary that allows time in Cusco or the Sacred Valley before a demanding trek is therefore valuable.
How to reduce the risk
- Ascend gradually: include acclimatisation time before sleeping higher or beginning strenuous activity.
- Take the first days gently: avoid heavy exercise and alcohol during the first 48 hours at altitude.
- Stay hydrated and eat normally: dehydration can worsen how you feel, although water alone does not prevent AMS.
- Do not climb with worsening symptoms: rest at the same altitude; descend if symptoms become severe or fail to improve.
- Discuss medication in advance: a doctor may recommend acetazolamide for some travellers, particularly when a rapid ascent is unavoidable.
- Review health conditions: travellers with heart or lung disease, pregnancy, sleep apnoea or previous severe altitude illness should seek personalised medical advice before departure.
What about coca tea?
Coca tea is part of Andean tradition and is widely offered to visitors. Some people find it comforting, but it should not be presented as a proven prevention or treatment for altitude illness. It must never replace gradual acclimatisation, descent or medical care. Coca products may also be illegal to carry into other countries and can affect drug-testing results.
Plan a gradual introduction to the Andes
Travellers concerned about altitude can begin with our private Cusco City Tour at a gentle pace or spend time in the Sacred Valley before trekking. Compare the altitude and difficulty of the Classic Inca Trail, Salkantay Trek, Lares Trek and Huchuy Qosqo Trek. We can help arrange an itinerary with suitable acclimatisation days.
This guide provides general travel information and is not a substitute for advice from a qualified medical professional.