Cusco, the ancient capital of the Inca Empire, is one of the most fascinating destinations in the world. However, there’s one thing that many travelers underestimate when planning their adventure: the Andean altitude. At more than 3,400 meters above sea level, it is normal for visitors to feel the effects  of soroche or altitude sickness. Fortunately, with the right preparation, you can enjoy Cusco without any surprises.

A woman traveler drinking a hot cup of coca tea for altitude acclimatization in the center of Cusco
The Cusco Cathedral and the flag of Cusco flying in the Plaza de Armas under a blue sky

What is altitude sickness?

Altitude sickness in Cusco occurs when the body does not adapt quickly enough to the decrease in oxygen at high elevations. Its most common symptoms include:

  • Headache
  • Nausea
  • Dizziness
  • Fatigue
  • Difficulty sleeping

Although it is usually mild, in some cases it can become more serious if not treated properly.

Man sitting in front of a meal representing loss of appetite as a symptom of altitude sickness
Man lying in bed looking at the ceiling, illustrating difficulty sleeping as an effect of high altitude adjustment
Close-up of a man holding his head due to a headache, a common symptom of altitude sickness in high elevations

When does it occur?

Symptoms of altitude sickness in Cusco can appear in the first 6 to 24 hours after arriving in Cusco, especially if you are coming from places at sea level such as Lima or abroad.

Tips to prepare before arriving in Cusco

  1. Progressive acclimatization: If possible, spend a few days in an intermediate location, such as Arequipa or the Sacred Valley, before arriving in Cusco.
  2. Avoid strenuous activities on the first day: Give your body time to adjust.
  3. Hydrate well: Water is key to cellular oxygenation. Avoid alcohol and caffeine.
  4. See your doctor: Medications such as acetazolamide can help prevent symptoms, begin taking 2 days before you arrive
  5. Eat light: Opt for easy-to-digest meals for the first few days.
A hiker drinking water from a bottle while trekking in the lush green mountains of the Peruvian Andes
People walking across the wet Plaza de Armas in Cusco during a rainy day in the Andes
Group of tourists walking through a historic stone-walled street in Cusco near local shops

What to do if you are already in Cusco

  • Get plenty of rest. Don’t underestimate the importance of getting a good night’s sleep.
  • Coca infusions: Highly recommended by locals, they help improve circulation and oxygenation.
  • Supplemental oxygen: Many hotels and pharmacies offer small oxygen tanks.
  • Doctor’s visit: If symptoms worsen, seek professional care immediately.
Narrow traditional street in Cusco with tourists walking past shops selling colorful Peruvian textiles and souvenirs
The Cusco Cathedral and colonial balconies at the Plaza de Armas main square.

Bonus: Alternatives for a better adaptation

  • Arrive by train from Ollantaytambo: You will gain time at lower altitudes before climbing to Cusco.
  • Staying in the Sacred Valley: Urubamba (2,800 m) offers spectacular scenery and lower altitude.

Conclusion

Cusco is a destination that deserves to be fully experienced. Altitude doesn’t have to be an obstacle if you’re well-informed and prepared. With these tips, your trip will be full of memories and not unexpected surprises.