Cusco is a dream destination for many. In fact, if you want to go to Machu Picchu, you will likely be stopping by this city nestled in the Andes. Cusco is a gorgeous destination that definitely warrants a visit, but the altitude in Cusco can be brutal. Cusco is high, and for many, it’s the highest they will ever be. And with this high altitude comes the dreaded altitude sickness. But what exactly is it, and how can you avoid and deal with it?
We spent around 2 weeks in Cusco, and we had two very different experiences with the altitude (as you’ll be able to read below), so we’ve managed to compile quite a bit of information on how to deal with altitude sickness in Cusco, Peru.
This is an absolute MUST-READ if you will be visiting Cusco – ideally, before you leave. But if you are already in Cusco, and you’re dealing with altitude sickness, there are still some remedies that will be able to help. Better late than never!
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What Is the Altitude of Cusco and Machu Picchu?

Let’s talk numbers. Cusco is located at 3,399 meters (11,152 feet) above sea level. To put this into perspective, Cusco is higher than many popular mountain destinations around the world, so you likely won’t have even come close to something this high. For comparison, Denver, CO, the “Mile-High City,” sits at just 1,609 meters (5,280 feet), less than half the elevation of Cusco.
Cusco is higher than:
- Banff, Canada: 1,383 meters (4,537 feet)
- Chamonix, France: 1,047 meters (3,402 feet)
- Zermatt, Switzerland: 1,620 meters (5,315 feet)
- Table Mountain, South Africa: 1,086 meters (3,563 feet)
- Quito, Ecuador: 2,850 meters (9,350 feet)
- Ben Nevis, Scotland: 1,345 meters (4,413 feet)
Machu Picchu is a bit lower than Cusco at 2,430 meters (7,970 feet) above sea level. But keep in mind that if you hike to Machu Picchu (such as the Salkantay Trek), you will be climbing a little bit higher than Cusco for parts of it.
If you want to visit the famous Rainbow Mountain in Cusco as well, keep in mind that this mountain is even higher than Cusco at a whopping 5,200 meters (17,060 feet).
What Is Altitude Sickness?

So, what exactly is altitude sickness? Altitude sickness is what you get when you are exposed to high altitudes too quickly. At these high altitudes, your body struggles with lower oxygen levels, leading to a variety of unpleasant symptoms. In short, due to the lower oxygen levels, your body simply has a harder time functioning normally.
Every body is different, so the way your body deals with altitude sickness may not be the same as someone else’s. The severity often depends on factors such as fitness level, hydration, and the speed at which you gain altitude.
There are three types of altitude sickness:
- Acute mountain sickness (AMS): The mildest and most common form often likened to a hangover.
- High altitude pulmonary edema (HAPE): When the altitude sickness causes your lungs to fill with fluid. Requires immediate medical attention.
- High altitude cerebral edema (HACE): When the altitude sickness causes your brain to swell. Requires immediate medical attention.
In Cusco, you will very likely be dealing with AMS, but, of course, if your symptoms get worse, seek medical attention IMMEDIATELY.
Altitude Sickness Symptoms

As mentioned, everybody experiences altitude sickness a bit differently depending on numerous factors. For example, Lev only experienced an upset stomach, while I experienced almost every symptom on this list (lucky me).
But don’t worry; most people only deal with mild to moderate symptoms that disappear within a couple of days.
These are the most common altitude sickness symptoms you may experience in Cusco:
- Headache
- Nausea
- Vomiting
- Loss of appetite
- Upset stomach
- Fatigue and exhaustion
- Trouble sleeping
- Lightheadedness
- General feeling of being sick
- Pins and needles
- Swelling of hands and feet
How Common Is Altitude Sickness in Cusco?
Altitude sickness is so common in Cusco that you’ll find coca tea (a local remedy) served literally everywhere. Here’s the thing: basically anyone who ascends quickly to 3,352 meters (11,000 feet) and above will get AMS. And since Cusco is situated higher than that, and most people fly to Cusco from sea-level Lima, you will feel it almost as soon as you land.
The good news is the majority of people will only deal with mild symptoms of altitude sickness that will disappear in 1-3 days. The trick is to follow the tips below. If you don’t, you could be signing yourself up for some miserable days nursing a horrible headache and stomachache.
9 Tips to Avoid and Deal with Altitude Sickness in Cusco, Peru

Whether you’re already in Cusco or heading to the city soon, you’ve got to follow these top tips to avoid and minimize the symptoms of altitude sickness in Cusco, Peru. You’ll thank me later!!
1. Consult Your Doctor
While not a necessity, consider consulting your doctor if you’re worried about altitude sickness. Your doctor will be able to give you a prescription to help your body adapt to higher altitudes. But keep in mind that these altitude sickness medications generally need to be taken BEFORE you arrive in Cusco. Depending on what you get, you’ll need to take it anywhere between 1 and 24 hours before you arrive.
Hot tip: If you arrive in Peru without a prescription, you can head over to any pharmacy and ask for altitude sickness medicine (sorojchi pills) over the counter.
For more tips on things to bring with you on your trip, check out our complete Peru packing list.
2. Take It Easy

Don’t plan anything for the first couple of days in Cusco. Take it slow. Ideally, on the first day, don’t do much at all beyond walking around to find food and water. Avoid any strenuous activities. Even walking up San Blas can be hard for your body, so save all the tourist activities for later when your body is more settled and used to the altitude. And for sure, do NOT book any hikes for the first couple of days.
3. Stay Hydrated
Hydration is key. Drink plenty of water before and during your time in Cusco. You’ll be losing a lot more fluids than you think, so drink up! Some electrolytes wouldn’t hurt, either.
4. Avoid Alcohol
This is a biggie and, unfortunately, the first mistake we made when we arrived in Cusco. Alcohol can worsen any symptoms you have. Plus, drinking alcohol in high altitudes will make you drunker much faster than you think. Alcohol can also further dehydrate you, which does not help with altitude sickness.
If you want to drink alcohol, save it until you are no longer experiencing altitude sickness. If you even have a hint of a headache, avoid it altogether, as you may find yourself in the worst hangover of your life the next day or more.
5. Eat Light
Due to the change in pressure at high altitudes, your digestion will be a bit messed up in Cusco. So I recommend eating light. Avoid any heavy or greasy meals, especially in the beginning. One meal we really enjoyed the first couple of days in Cusco is caldo de gallina, chicken soup, which they’ll serve in basically any local restaurant.
6. Drink Coca Tea
Coca tea is a remedy that locals swear by. You’ll find coca tea all over Cusco, including on top of mountains. But you can also easily make it yourself by boiling some water and popping in a few coca leaves inside the cup to brew for a few minutes. You can add some sugar or honey to sweeten the tea before drinking.
Alternatively, you can simply chew on coca leaves, but this will be pretty bitter. We recommend always having some coca leaves on hand so that you can chew them when needed.
Hot tip: Beyond coca tea, many Peruvians swear by lemon candy, which we’ve found helps alleviate some of the symptoms too.
7. Get Some Agua de Florida
One other local remedy, which helped us alleviate symptoms immediately, is agua de florida. Agua de florida is a herby cologne that you spray onto your hands. Then, you place your hands to your nose and inhale deeply. We HIGHLY recommend purchasing one to keep in your bag as you explore Cusco and its surrounding areas.
8. Go Lower

Is nothing else working? Then, the best way to help alleviate your symptoms is to descend to a lower altitude. You don’t have to go too much lower. For example, you can head to the Sacred Valley (2,400 to 2,800 meters or 7,874 to 9,186 feet) or even Machu Picchu (2,430 meters or 7,970 feet). While I was dealing with a pounding headache (amongst other symptoms), heading to Machu Picchu was the big reset I needed.
9. Get Some Travel Health Insurance
Worst comes to worst, you want to ensure that you are covered. We’ve used SafetyWing as our chosen travel health insurance for the past couple of years, and we are very pleased with it. It is budget-friendly and more than covers all of our needs as full-time travelers. Importantly, SafetyWing covers travel delay, trip interruption, medical treatment, hospitalization, evacuation, and injuries from leisure sports and activities, inclluding hiking up to elevations of 6,000 meters (19,685 feet).
Even if you do not go with SafetyWing, just ensure that your chosen insurance covers you throughout your trip, including when you are at 5,200 meters (17,060 feet) when climbing Rainbow Mountain.

My Experience with Altitude Sickness in Cusco


Let this be a cautionary tale. I have yet to meet anybody who has had it worse than me in terms of altitude sickness in Cusco. So, keep in mind that this will VERY likely not be your own experience. I just want to show you how bad it can be if you don’t follow the tips and take care of your body.
So, as mentioned previously, I made a few rookie mistakes:
- I did not bring any altitude sickness medications, and by the time I was in Cusco, it was too late.
- I drank alcohol within the first couple of days when I was still dealing with debilitating headaches, amongst other symptoms.
- I did not hydrate often.
- I did not energize my body with food, as I had lost all of my appetite.
- I went to a higher altitude when already dealing with terrible symptoms.
Medication is not the biggest necessity (although it certainly helps), so barring that, my first biggest mistake was going on a pub crawl. While you can enjoy a night out in Cusco, do NOT drink if you are experiencing any of the above altitude sickness symptoms. At the very least, you will be dealing with a terrible hangover the next day, no matter how little you drink. At worst, like in my case, this will snowball into worsening altitude sickness symptoms that eventually led to mistakes number 3 and 4.
As I did not have an appetite, I failed to replenish my body with what it needed to tackle the altitude sickness. So, in the end, I dealt with altitude sickness symptoms for a whopping 2 weeks.
And finally, when I was already dealing with altitude sickness, I had the brilliant idea of climbing Rainbow Mountain, which is 1,800 meters (roughly 6,000 feet) higher than Cusco. During this hike, I dealt with the worst of my symptoms. And thinking back, I wonder what on earth possessed me to put myself through all that when I was already unwell and in bed (travel guilt, I guess!).
But Don’t Worry… My Experience Is Not the Norm
With all that said, most people will only deal with altitude sickness for the first day or two, after which they will have mild to no issues. The one other person I know of who had longer-lasting symptoms simply did not have an appetite her whole trip (but she was well enough otherwise to be out and about all day), so she barely ate anything for two weeks and came back to Lima having lost almost 10 kilos. Yikes.
FAQ
Do I need altitude sickness pills for Cusco?
While you do not need altitude sickness pills for Cusco, they can be helpful in terms of battling the symptoms. However, keep in mind that you would need to start taking them before you arrive in Cusco – this can be between 1 and 24 hours, depending on the type of pill you get.
How long does it take to acclimate to altitude in Cusco?
On average, it takes around 2 to 3 days to acclimate to the altitude in Cusco. Cusco is very high, so you will feel the altitude the moment you land at the airport as you carry your bags to the taxi, so take it easy for the first few days before doing any activities.
Does coca tea help with altitude sickness?
There’s a reason coca tea is a local remedy. While there is no hard evidence that supports it, it is known to alleviate mild altitude sickness, including symptoms like headaches and an upset stomach. You could even chew on the coca leaves themselves.
How long does an altitude headache last?
This highly depends on the person, but it can last anywhere between 1 and 5 days.
Altitude Sickness? Never Heard of Her (Just Kidding).
Okay, okay… Truth is, I totally have. But if you follow my advice, you needn’t experience what I did. And even if you are prone to altitude sickness like me, with some preparation, you’ll be able to better weather your symptoms and maybe even avoid altitude sickness altogether. I definitely made a few mistakes during my time in Cusco that worsened my experience with altitude sickness. Although that may have soured my time in Cusco a bit, the good news for you is that I can arm you with all the advice I wish I would’ve had before and during my trip!
Don’t underestimate how bad altitude sickness can get. So, take my advice, prepare your pills, don’t drink, stock up on coca leaves, and you’ll be golden!