Altitude sickness in Cusco: how to prevent and beat it
Cusco sits at about 3,400 metres — higher than many people have ever been. Mild altitude sickness, known locally as soroche, is extremely common in the first day or two and almost always passes. Knowing what to expect, and how to help your body adjust, makes all the difference between a rough start and a smooth trip.
What altitude sickness actually feels like
As you go up, the air holds less oxygen, and your body needs time to make more red blood cells to compensate. Until it catches up, you may feel a headache, mild nausea, shortness of breath, tiredness or trouble sleeping. This is normal and usually fades within 24 to 48 hours.
Severe, worsening headache, vomiting, confusion, breathlessness at rest or a persistent cough are warning signs. They are uncommon, but if they appear you should descend and seek medical help promptly. Tell your guide immediately — our teams carry oxygen and a first aid kit on every trek.
How to acclimatize the right way
The single best thing you can do is arrive a day or two early and take it easy. Do not fly into Cusco and start a hard trek the same day. Give your body a gentle window to adjust before you ask anything of it.
- Spend your first day in Cusco resting and walking slowly — no big hikes.
- Drink far more water than usual, and sip coca tea, which locals have trusted for centuries.
- Eat light, carbohydrate-rich meals and avoid heavy, greasy food.
- Skip alcohol and limit caffeine for the first 48 hours.
- Consider starting in the lower Sacred Valley (around 2,800 m) before Cusco itself.
A simple altitude reference
| Place | Altitude | How most people feel |
|---|---|---|
| Sacred Valley (Urubamba) | ~2,800 m | Gentle — a good place to start |
| Cusco | ~3,400 m | Mild soroche common day 1–2 |
| Dead Woman’s Pass (Inca Trail) | 4,215 m | Hard effort, short exposure |
| Salkantay Pass | 4,630 m | Demanding; acclimatize first |
| Rainbow Mountain | 5,020 m | Very high; slow and steady wins |
Medication and when to ask a doctor
Some travelers take acetazolamide (Diamox) to help acclimatize, but whether it is right for you is a medical decision — talk to your doctor before you travel, not us. We are guides, not physicians, and we will always err on the side of your safety on the mountain, including adjusting the pace or descending if needed.
Planning a high-altitude trek?
We build acclimatization into every itinerary. See routes that ease you up gradually.
Frequently asked questions
Mild symptoms usually ease within 24 to 48 hours as your body adjusts. Arriving a day or two early gives you the best start.
Many travelers find coca tea eases mild symptoms and it has been used in the Andes for centuries. It is widely available and offered free in most Cusco hotels.
That is a decision for your doctor, who knows your medical history. Ask them before you travel rather than self-prescribing.
Mild symptoms on day one are normal and usually pass. Always tell your guide how you feel — our teams carry oxygen and adjust the pace for your safety.