If you're planning a trip to Cusco, there's one thing you probably can't stop thinking about: the altitude.
At around 3,400 metres (11,150 feet) above sea level, Cusco is high enough that even simple activities like walking uphill can feel surprisingly difficult. But reading about altitude sickness and experiencing the effects of high altitude yourself are two very different things.
We visited Cusco as a family of three — two adults and our 15-year-old — and I quickly realized that knowing what to expect is one thing, but figuring out how your body will actually react is another.
Here's what the altitude felt like for us, how it affected our first few days, and what helped us adjust during our time in Cusco.
Planning a trip to Peru?
I put together our complete 16-day Peru itinerary, including Cusco, the Sacred Valley, Machu Picchu, Paracas, Huacachina and the Amazon.
Arriving in Cusco: "Why is breathing so hard?"
We arrived in Cusco around noon after a LONG travel day. We had an 8-hour overnight flight, a connection and basically zero sleep. The second we stepped off the plane, we could feel something was different.
Breathing felt harder.
We were all a little short of breath, and I felt dizzy and completely exhausted. Of course, it was hard to tell what was altitude and what was simply being awake for way too long.
Then we got to our B&B. And there were stairs. About 10 of them.
Those 10 stairs suddenly felt like 50.
By the time we got to the top, our hearts were pounding and we were breathing heavily.
I remember thinking, Okay... this is going to be interesting. 😂
We got to our room and decided to lie down for a couple of hours. We planned on taking a quick nap. Instead, we completely crashed and woke up much later in the evening, just in time to go out for dinner.
And honestly? That nap helped a lot.
What does altitude actually feel like?
For me, the strangest part was how different breathing felt.
It wasn't that I couldn't breathe. It just felt like my body had to work much harder to do it.
Walking uphill or climbing stairs made my heart pound like crazy. Even simple things suddenly felt like a workout.
Sleeping was also weird.
We all had a little insomnia, and even turning over in bed sometimes felt like a chore. You move a little, and suddenly your heart starts pounding like you just ran up a hill.
Our teenager had some shortness of breath too, but nothing major.
My husband had a headache and took Advil.
I didn't get a headache — and surprisingly, I didn't get one of my usual migraines either.
That was a big win for me. I was actually pretty nervous about it
I have allergies and sometimes have asthma-like symptoms, so I was honestly worried about how I'd react. I was scared I'd get to Cusco and have trouble breathing. Thankfully, that didn't happen.
I didn't need to use my inhaler at all.
Obviously, everyone reacts differently to altitude, so I'm only sharing what happened to us.
We didn't take altitude medication.
We didn't take anything before arriving specifically for altitude sickness.
There are prescription medications, such as acetazolamide (Diamox), that doctors may recommend for some travelers depending on their health and itinerary.
We didn't use anything like that.
The only medication we used was Advil (ibuprofen) when needed. My husband took it for his headache. It can help with some altitude-related headache symptoms, but it's not a treatment for serious altitude sickness.
Coca tea, coca candies and muña tea
We also tried the traditional Peruvian options. Coca tea in the morning. Coca candies throughout the day. Muña tea before bed.
Did they actually help? Honestly... I have no idea. 😂
Maybe they did. Maybe it was the placebo effect.
But we definitely enjoyed them.
And the coca candies? We were eating those things like they were chips.
Hydration became VERY important
One thing I didn't really think about before Peru was how dry Cusco feels.
At high altitude, you're breathing differently and the air is dry, so staying hydrated becomes even more important — especially when you're walking and hiking.
We drank plenty of water and used electrolytes. Ours also had magnesium, which I felt helped with muscle recovery, although I obviously can't say for sure.
The biggest thing was simply making sure we were drinking regularly instead of waiting until we felt awful.
And pack for the dryness!
The altitude wasn't the only thing our bodies noticed.
Our nose, lips and skin were SO dry.
I used a saline nasal spray to help with the dryness and irritation.
And lip balm was a must. Seriously, bring lip balm. 😂
I was constantly putting it on.
I also used a good moisturizer/face cream because the combination of dry air, cold, wind and sun definitely made my skin unhappy.
My little Cusco packing list:
If you're going to Cusco, I'd bring:
- 💧 Reusable water bottle
- 🧂 Electrolytes
- 👃 Saline nasal spray
- 💋 Lip balm
- 🧴 Face moisturizer
- ☀️ Sunscreen
- 🧢 Hat
- 🧥 Layers
- 👟 Comfortable walking shoes
- 🎒 Small day bag
Want to see some of my travel essentials?
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One thing that made me feel better: oxygen
Something I noticed while staying in Peru is that many hotels and B&Bs in Cusco are prepared for altitude. Several places we stayed offered oxygen or had oxygen available in case guests needed it.
Knowing that was there honestly made me feel a little better, especially during those first couple of days. It's definitely worth asking your hotel or B&B about it before you arrive.
Day 2: Pisac
By the second day, we already felt noticeably better. We decided to take a collectivo to Pisac.
Maybe slightly ambitious after struggling with 10 stairs the day before... but we felt okay enough to go. 😂
We walked, explored and eventually did a pretty long hike with A LOT of stairs.
Our hearts were pounding and we were breathing heavily, but we were okay.
And yes, the coca candies were coming out constantly.
By the end of the day, I felt like my body was finally starting to understand what was going on.
By Day 3...
By our third day in Cusco, thankfully, there were no major altitude issues.
We still noticed it. Hills and stairs? Still humbling. 😂
Our hearts would start pounding and we'd get short of breath much faster than normal.
But it wasn't scary anymore.
It was more like: "Okay, this is just what breathing at 3,400 metres feels like."
We still had a little insomnia, but overall we were feeling much more comfortable.
Then came Ollantaytambo - Machu Picchu
We traveled to Machu Picchu on our third night, which I think also helped.
Machu Picchu and Aguas Calientes are much lower than Cusco, so it was nice to get down to a lower elevation after those first couple of days.
Some people actually prefer to visit the Sacred Valley and Machu Picchu before Cusco because the elevations are generally lower and it can give you more time to acclimatize.
I can definitely see why people do it that way. But honestly, I liked how we did our trip.
We spent a couple of days in Cusco, took it relatively easy, did Pisac on day two and then went to Machu Picchu on our third night.
For us, it worked.
What I'd recommend based on our experience
If I could give you just a few tips, they would be:
Take your first day seriously.
Don't land in Cusco and immediately try to see everything. We arrived around noon, napped and went for dinner. That was enough.
Go slow.
Those stairs aren't going anywhere. 😂
Drink your water.
And bring electrolytes if you like using them.
Pack for the dry air.
Saline spray, lip balm and moisturizer were things I was very happy to have.
Give yourself time.
Your body needs to adjust.
Ask your hotel about oxygen.
Many hotels and B&Bs catering to travelers are prepared for altitude-related issues, but it's worth confirming what your specific property provides.
And listen to your body.
Don't just push through symptoms that are severe, getting worse or feel unusual for you.
So... was Cusco altitude terrible?
Honestly? Not terrible. Just humbling.
The first few hours were definitely the weirdest.
Breathing felt different. Our hearts were pounding. Ten stairs felt like a hike. Sleeping wasn't quite normal.
But we gave ourselves time to adjust, stayed hydrated and didn't try to do too much right away.
And by the third day, we were hiking around Pisac, eating coca candies like popcorn and getting ready for Machu Picchu.
So if you're worried about Cusco altitude, don't automatically assume your trip is going to be miserable.
Just respect the altitude, slow down, hydrate and give your body time to catch up with your itinerary.
And if you want to see exactly how we planned the rest of our trip:
Because in Peru, sometimes the hardest part of the day isn't the hike.
It's the stairs to your hotel room. 😂
This post is based on our family's personal experience in Cusco. Altitude affects everyone differently, and this isn't medical advice. If you're concerned about altitude sickness or have a medical condition that could be affected by high altitude, talk to your doctor before traveling.
This post contains affiliate links. If you purchase something through one of my links, I may earn a small commission at no additional cost to you. Thank you for supporting my blog and helping me keep creating travel content! ❤️
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