Altitude in Peru: Acclimatization and Physical Preparation Guide

Traveling through Peru’s high-altitude regions is an unforgettable experience, but it’s important to understand how elevation affects your body before exploring places like Cusco, the Sacred Valley, and Machu Picchu. 

This FAQ brings together the key points on how to acclimatize safely, what symptoms to expect, and how to prepare for altitude-related challenges. Whether you’re planning your visit through the Peru Travel FAQ for first-time visitors, training for highland hikes, or simply flying directly from Lima to Cusco, these insights will help you feel confident and comfortable throughout your journey. 

You’ll also find references to our Machu Picchu Guide and Safety & Health sections for deeper advice on hiking conditions, physical effort, and staying well at elevation.

How to prepare for high altitude before arriving in Cusco?

Arrive gradually, hydrate well, and avoid alcohol and heavy meals on your first day.

Visitors are advised to spend their first night at low altitude locations like Lima or the Sacred Valley before ascending to Cusco at 3,400 m (11,150 ft).
Hydration is crucial: drink plenty of water while limiting caffeine and alcohol intake.
Light walking aids acclimatization, and consuming traditional mate de coca (coca leaf tea) is a local remedy to alleviate mild symptoms of reduced oxygen levels.

Sources:

• Ministry of Health and PromPerú
• CDC Traveler’s Health
• Local guides and PeruRail recommendations

How long does it take to adjust to altitude in the Andes?

Most travelers adjust in 1–3 days.

Mild symptoms such as headaches or fatigue are common in the first 24–48 hours. Avoid strenuous exercise and allow your body to acclimate gently. The Sacred Valley, at a lower altitude (about 2,800 m), offers easier acclimatization compared to Cusco.

Sources:

• US CDC
• Ministries of Health and Tourism, Peru

What medications help prevent altitude sickness (e.g., Diamox)?

Acetazolamide (Diamox) is the most effective medication for prevention.

Take acetazolamide 24 hours before ascending and continue for 2–3 days. Over-the-counter oxygen or coca tea can help relieve mild symptoms but consult a doctor prior to use of any prescription medication. Sorojchi pills are commonly available locally without prescription.

Sources:

• CDC Yellow Book
• Peruvian pharmacies and Ministry of Health guidance

Can I exercise at high altitude in Cusco?

Light activity is fine, but intense exercise should wait until you acclimate.

At 3,400 m, oxygen levels are about 35% lower than at sea level, reducing endurance and increasing fatigue. Gentle walks around Cusco’s historic areas or easy hikes in the Sacred Valley are recommended while acclimating.

Sources:

• PromPerú
• Local travel health advisories

What’s the best order to visit: Lima → Sacred Valley → Machu Picchu?

Yes, that order helps with altitude adjustment.

Ascending gradually from sea level in Lima to the lower altitude Sacred Valley (about 2,800 m) before reaching Cusco (3,400 m) and finally Machu Picchu (2,430 m) is the safest approach to minimize altitude sickness risk.

Sources:

• CDC
• Peru Ministry of Health

What’s the altitude in Cusco and Machu Picchu?

Cusco sits at 3,400 m (11,150 ft); Machu Picchu is lower at 2,430 m (7,970 ft).

Cusco’s elevation can induce shortness of breath and mild headaches in visitors unaccustomed to altitude.
Machu Picchu’s lower altitude means most travelers experience little to no altitude-related discomfort there.

Sources:

• PromPerú
• Ministry of Health, Peru

Can kids or older adults handle the altitude?

Yes, with care. Children and seniors can travel safely if they acclimate slowly.

By taking time to rest, staying hydrated, and avoiding rapid elevation changes, most seniors and children adapt well. Hotels and tours often provide supplemental oxygen, which may be particularly helpful for older travelers.

Sources:

• CDC
• US Embassy Lima

What happens if I get altitude sickness, are there clinics?

Yes, Cusco and the Sacred Valley have clinics equipped for altitude-related care.

Many hotels offer oxygen tanks, and medical visits can be arranged promptly.
Clinics such as Clínica San José and O2 Medical Network in Cusco specialize in altitude sickness and traveler care.

Sources:

• US Embassy Peru
• PromPerú
• Local healthcare providers

Do I need oxygen for Machu Picchu?

No, oxygen is not needed for most travelers.

Most visitors tolerate Machu Picchu’s moderate altitude without supplemental oxygen; however, those severely affected by altitude sickness in Cusco might require it. Portable oxygen is widely available in Cusco hotels and with tour operators.

Sources:

• Ministry of Health, Peru
• PromPerú

With the right preparation, altitude doesn’t need to limit your experience in Peru. Most travelers adjust within a day or two, especially when they follow a gradual ascent, stay hydrated, rest on arrival, and balance their itinerary wisely. 

Once you’ve reviewed these acclimatization tips, you can continue planning your trip with our detailed guides on Machu Picchu, Transportation & Itineraries, and Safety & Health, which cover everything from train routes to trail difficulty and what to expect during high-altitude travel. With thoughtful planning, you’ll be ready to enjoy Peru’s mountains, culture, and landscapes at your best.