Altitude Sickness in Cusco; How to Avoid?

Altitude sickness, also known as acute mountain sickness (AMS), occurs when your body struggles to adjust to the reduced oxygen levels at higher altitudes. It’s common above 8,000 feet (2,400 meters), but some individuals are sensitive to lower altitudes. Symptoms can range from mild to severe and include headache, nausea, fatigue, and difficulty sleeping. In severe cases, it can lead to high-altitude pulmonary edema (HAPE) or high-altitude cerebral edema (HACE), which can be life-threatening.

What is altitude sickness?

Let’s start by looking at what high altitude means. High altitude starts to have an effect on our bodies from between 1,500m – 2,000m (4921ft – 6561ft). Our bodies start to react differently to make up for the changes in oxygen levels.

So, as you go higher the air pressure gets lower (the air gets ‘thinner’) so that for every breath there will be less oxygen for your body. Your body gradually adapts to getting less oxygen. You breathe faster and deeper and the body produces more red blood cells to carry oxygen molecules. This takes time, so this is why if you go from low to high altitude too quickly, you may feel symptoms of altitude sickness until your body acclimatizes.

Cusco is located at an altitude of 3,400 meters (11,200ft). It is common for many visitors to experience some mild symptoms of altitude sickness or ‘soroche’ as it is known locally. It’s hard to tell if you will be affected by altitude sickness, Some people can be more susceptible than others regardless of age, sex or physical condition.

How to Prepare for High Altitude in Cusco

Before your trip, use these tips to help your body better handle high altitudes:

Improve your aerobic fitness beforehand: Activities like running, swimming, or hiking improve cardiovascular efficiency, helping your body use oxygen better in high-altitude conditions.
Build strength: Focus on leg and core exercises to prepare for treks like the Salkantay, which require endurance.
Stay hydrated: Start hydrating a few days before your trip, as higher altitudes will require your body to use more water.

Cusco altitude: What to Expect & Symptoms of Altitude Sickness

At 3,400 meters (11,152 feet), Cusco is significantly higher than most travelers are accustomed to. Altitude sickness can strike quickly, especially if you fly directly to Cusco from a lower elevation. Symptoms often include:

• Headaches
• Dizziness
• Nausea
• Fatigue
• Shortness of breath

Acclimatization Tip: Arriving by bus from lower elevations (like Arequipa) allows for a gradual ascent, reducing the risk of altitude sickness. If you fly directly, take extra precautions during your first 24–48 hours in Cusco.

** The best place to get used to the altitude is the Sacred Valley; Ollantaytambo.

Acclimatizing in Cusco vs. Sacred Valley

Cusco isn’t your only option for adjusting to the altitude. The Sacred Valley is located at 2,800 meters (9,186 feet), which is notably lower. For many travelers, spending the first day or two on a Sacred Valley tour or on a Machu Picchu tour (lower altitude at 2,430 meters/7,972 feet) helps the body adjust much better.

** Recommened Hotel at Ollantaytambo; Andenes del Inca Hotel

Altitude sickness prevention tips for Cusco

When you arrive in Cusco, take it slow. Here’s how to adjust smoothly:

• Drink coca tea: A traditional remedy, coca tea is widely available and can help ease mild symptoms
• Hydrate: The dry mountain air increases water loss, so drink plenty of fluids.
• Rest and take it easy: Minimize physical activity during your first 24 hours.
• Eat light meals: High-carb foods are easier to digest and provide energy.

Eight tips to avoid altitude sickness in Cusco

• Relax and take it easy! Take a few days at the start of your trip to acclimatize to the altitude before attempting any treks or strenuous activity. This is the best advice we can share! Take it easy for the first few days and your body will thank you later.
• Get lots of sleep. Sleep is the best remedy of all!  Do not be afraid to just sleep it off as your body adjusts.
• Avoid alcohol & drugs.  This includes sleeping tablets and tranquilizers as these can all make the symptoms worse.
• Drink lots of water. Staying hydrated prior to and throughout your trip is crucial to avoiding unpleasant altitude sickness symptoms.
• Drink coca tea. Nearly every hotel in Cusco and the Sacred Valley offers fresh coca tea to guests and for a good reason too! Coca tea is completely safe to drink and a cup or two each day can ease altitude symptoms.
• Go lower to acclimatize. Head straight to the lower altitude of the Sacred Valley or Machu Picchu. Believe it or not, Cusco is at an altitude of 3400m (11,154ft) so heading to Ollantaytambo at 2,900m (9,514ft) or Machu Picchu at 2,400m (7,874ft) can make a huge difference
• Get an Oxishot. Oxishot is a small dischargeable can that contains 8 litres of oxygen that you can take when you arrive in Cusco and anytime you need a boost. It can help reduce headaches and fatigue associated with altitude sickness.
• Visit your doctor. If you are still worried before you to travel, head to your doctor and ask for an acetazolamide prescription (also known as brand name Diamox) which can be taken to help avoid altitude sickness symptoms. Regardless of altitude worries, you should always visit your doctor or a travel clinic prior to travel to Peru.
• Medical practitioners and hospitals in Cusco are quite used to treating altitude sickness, so if something does go wrong there are medical facilities available here. There are several private clinics who offer doctors fluent in English.