Altitude Sickness by Destination: Kilimanjaro, Everest Base Camp, Cusco and More
How high the most popular high-altitude trips go, how risky each is, and when preventive tablets are worth discussing.
Part of the Access Doctor Altitude Sickness Guide.
Key fact: Risk depends on how fast you gain height, not just how high you go. Kilimanjaro and a flight straight into Cusco or La Paz are higher risk than their popularity suggests.
Thousands of UK travellers go above 2,500m every year, often on trips sold as holidays rather than expeditions. This guide gives the heights involved and what they mean for your risk. Heights are approximate. For symptoms and treatment, see our guide to altitude sickness.
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Start Altitude Sickness Consultation →Destinations at a Glance
| Destination | Height | Why it matters |
|---|---|---|
| Kilimanjaro, Tanzania | 5,895m summit | Fast ascent on most routes; under 7 days is high risk |
| Everest Base Camp, Nepal | 5,364m | Starts with a flight to Lukla (about 2,860m); rest days are essential |
| Cusco, Peru | About 3,400m | Most visitors fly straight in from sea level |
| Machu Picchu, Peru | About 2,430m | Lower than Cusco; the Inca Trail crosses a pass at about 4,200m |
| La Paz, Bolivia | About 3,650m (airport about 4,050m) | One of the highest arrivals by air in the world |
| Lhasa, Tibet | About 3,650m | Usually reached by air or train in one go |
| Leh, Ladakh, India | About 3,500m | Most visitors fly in from Delhi |
| Quito, Ecuador | About 2,850m | Mild symptoms are common in the first days |
| Mont Blanc, France | About 4,800m summit | Often climbed in 2 to 3 days from the valley |
Kilimanjaro
Kilimanjaro is the trek where UK travellers most often get altitude sickness. It’s nearly 5,900m high, needs no climbing skills, and most routes take only 5 to 8 days, which is faster than the 500m-a-day rule allows. UK travel health guidance classes Kilimanjaro in under 7 days as high risk.
- Choose a longer route: 8 or 9 days gives your body far more time to adjust than 5 or 6
- Preventive tablets are commonly advised, because the ascent is fast whichever route you take
- Ask your operator what oxygen, checks and evacuation plans they have
Everest Base Camp and Nepal
The Everest Base Camp trek reaches about 5,364m. A standard 12 to 14-day itinerary includes rest days at Namche Bazaar (about 3,440m) and Dingboche (about 4,400m), which fits the ascent rules. The risk comes from cutting those days, or from flying to Lukla and pushing on while tired.
The Annapurna Circuit crosses the Thorong La pass at about 5,400m, and needs the same care. On well-paced Nepal treks, tablets aren’t always needed, but they’re worth discussing if you’ve had altitude sickness before or your schedule is tight.
Cusco, Machu Picchu and the Inca Trail
Machu Picchu itself is only about 2,430m, where altitude sickness is uncommon. The risk is Cusco, the gateway city at about 3,400m, where most people arrive by air from Lima at sea level.
- Go down first: travel straight from Cusco airport to the Sacred Valley (about 2,800m) for your first nights, and visit Cusco later
- Take 2 to 3 easy days before starting the Inca Trail, which crosses a pass at about 4,200m
- Tablets are worth discussing if you’re flying straight into Cusco, especially if you’ve had altitude sickness before
Rainbow Mountain, a popular day trip from Cusco, reaches about 5,000m. Leave it until the end of your stay.
High Cities: La Paz, Lhasa, Quito, Leh
Arriving by air gives your body no time to adjust. In La Paz, Lhasa and Leh, many visitors have a headache and feel tired or sick for the first day or two. Plan nothing strenuous for 48 hours, avoid alcohol, and don’t travel higher until you feel well. Quito is lower, and symptoms there are usually mild.
The Alps and Ski Resorts
Most Alpine ski resorts are below 2,500m where you sleep, so altitude sickness is uncommon, though mild headaches and poor sleep can happen in the highest resorts. Climbing Mont Blanc (about 4,800m) is different: it’s often done in 2 to 3 days, so spending a few nights at huts above 2,500m beforehand is recommended.
When Tablets Are Worth Discussing
- Kilimanjaro, on any route
- Flying straight to above 2,800m (Cusco, La Paz, Lhasa, Leh)
- Any trek that gains more than 500m of sleeping height a day above 3,000m
- A previous episode of altitude sickness, whatever the trip
The medicine used is acetazolamide; see acetazolamide for altitude sickness. Tablets work alongside a sensible itinerary, not instead of one: read how to prevent altitude sickness.
Tell Us About Your Trip
Tell us about your trip and your health. A UK pharmacist prescriber checks whether preventive treatment is suitable for you. Approved before 3pm, Mon–Fri? Dispatched the same day.
Start Altitude Sickness Consultation →Frequently Asked Questions
Do I need altitude sickness tablets for Kilimanjaro?
They're commonly advised. Most Kilimanjaro routes go up faster than the recommended 500m a day, and UK guidance classes climbing it in under 7 days as high risk. A longer route and preventive tablets both lower your risk.
Do I need altitude sickness tablets for Machu Picchu?
Machu Picchu is about 2,430m, where altitude sickness is uncommon. The risk is Cusco at about 3,400m. Tablets are worth discussing if you're flying straight into Cusco or walking the Inca Trail.
Do I need altitude sickness tablets for Everest Base Camp?
Not always. A standard 12 to 14-day trek with rest days follows the ascent rules. Tablets are worth discussing if you've had altitude sickness before, or if your itinerary is shorter than usual.
Can you get altitude sickness in Cusco?
Yes. Cusco is about 3,400m and most visitors fly in from sea level, so headache, tiredness and nausea are common in the first day or two. Spending your first nights lower, in the Sacred Valley, helps.
Can you get altitude sickness skiing in the Alps?
It's uncommon, because most Alpine resorts are below 2,500m where you sleep. Mild headaches and poor sleep can happen in the highest resorts for the first night or two.
Which is harder for altitude: Kilimanjaro or Everest Base Camp?
Kilimanjaro, for most people. It's higher and is usually climbed in about half the time, so there's less chance to acclimatise. Everest Base Camp treks are longer and include rest days.
References
- NaTHNaC, TravelHealthPro. Altitude illness. travelhealthpro.org.uk
- Fit for Travel (Public Health Scotland). Altitude and travel. fitfortravel.nhs.uk
- Luks AM, et al. Wilderness & Environmental Medicine. Wilderness Medical Society clinical practice guidelines for the prevention, diagnosis and treatment of acute altitude illness: 2024 update. journals.sagepub.com
- NHS Specialist Pharmacy Service. Using medicines for preventing acute mountain sickness. sps.nhs.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Prescription medicines require a consultation before they can be dispensed. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.