Cusco Altitude: How High Cusco Is and How to Handle Your First Days There

How High Is Cusco Above Sea Level?

Cusco sits about 11,150 feet, or 3,400 meters, above sea level at the Plaza de Armas. Hillside neighborhoods such as San Blas and San Cristóbal climb a few hundred feet higher, and the Sacsayhuamán ruins above town reach roughly 12,100 feet. Cusco is one of the highest major cities in the Americas.

Elevations are rounded and vary slightly by source.

Sacsayhuamán, the highest point most visitors reach in town, has its own guide to the Inca walls above Cusco.

How Does Cusco's Elevation Compare With US Cities and Peaks?

Cusco's elevation of about 11,150 feet is higher than any US city. It sits above Denver at 5,280 feet, Santa Fe at about 7,200 feet and Leadville, Colorado at about 10,150 feet. Many Colorado ski summits reach similar heights, but visitors only touch them briefly instead of sleeping there.

For the full picture, start with our Cusco, Peru guide.

Sleeping altitude matters most. Visiting a high summit for an hour is very different from spending nights at Cusco's height.

Will You Get Altitude Sickness in Cusco?

Many visitors feel some altitude sickness in Cusco, usually headache, shortness of breath on stairs, poor sleep or low appetite during the first day or two. Fitness does not predict who gets it. Age, flying straight from sea level, previous altitude problems and how fast you exert yourself on arrival matter more.

Most cases are mild acute mountain sickness that fades as the body adjusts. Serious forms, high altitude pulmonary or cerebral edema, are rare at Cusco's height but need urgent care. Machu Picchu itself is lower, a point covered in our Machu Picchu elevation guide.

• Headache, often worse at night.
• Breathlessness when walking uphill or climbing stairs.
• Nausea or loss of appetite.
• Trouble sleeping and waking often.
• Tiredness or lightheadedness.

What Should You Do in Your First 48 Hours in Cusco?

In your first 48 hours in Cusco, move slowly, drink water, eat light meals and skip alcohol on the first night. Keep day one to an easy walk around the Plaza de Armas, rest in the afternoon, and save Sacsayhuamán, Rainbow Mountain or long hikes for day three or later.

1. Take a taxi or transfer from the airport rather than walking with bags.
2. Rest for an hour or two after check-in.
3. Walk gently on flat streets around the center.
4. Drink water steadily and try coca tea if you like.
5. Eat a light dinner and avoid alcohol the first night.
6. Add short climbs like San Blas on day two.
7. Plan big hikes from day three, after you feel well.

Classic remedies, including coca tea, Diamox and oxygen, are compared in our Machu Picchu elevation guide.

Should You Go to the Sacred Valley Before Cusco?

Going to the Sacred Valley before Cusco is a smart way to acclimatize. Towns like Urubamba and Ollantaytambo sit around 9,200 feet, about 2,000 feet lower than Cusco, so your first nights are easier. Many itineraries drive straight from Cusco airport to the valley, then return to Cusco after Machu Picchu.

This order also puts you close to the Ollantaytambo train station. See our Sacred Valley tour for the sights along the way.

If you are also weighing this, see our Lima to Cusco guide.

How Do Cusco Hotels Help With the Altitude?

Some Cusco hotels help with the altitude by offering oxygen-enriched rooms, bottled oxygen at reception and free coca tea in the lobby. Oxygen-enriched rooms add oxygen to the air to lower the effective altitude while you sleep. They cost more, so they suit travelers who sleep badly at altitude or have short trips.

Ask about stairs too. Hillside hotels in San Blas often mean steep steps, which feel hard on day one.

When Should You See a Doctor for Altitude Sickness in Cusco?

See a doctor in Cusco if altitude symptoms get worse instead of better, if you are breathless while resting, have a cough with frothy sputum, confusion, trouble walking straight or a severe headache that does not ease. These can signal serious altitude illness. Descending to lower altitude is the main treatment, along with oxygen.

Talk to your US doctor before the trip about prescription medicine such as acetazolamide, especially if you have heart, lung or blood pressure conditions, or are pregnant. Travel insurance with medical cover is wise; see our Machu Picchu cost guide for budgeting it.

For a fully arranged version, take a look at our Machu Picchu tours for seniors.

Acclimatization days in Cusco are easier with gentle sightseeing, such as things to do in Cusco, and a lower base like the Pisac ruins and market.