Is it better to take a train or fly to Cusco?

Flying is faster, but arriving by bus from a lower altitude allows for better natural acclimatization. If you fly, be prepared to feel the effects immediately.

How long does it take to fully adjust?

Most people feel significantly better after 48 to 72 hours of steady hydration and low activity.

When should I seek medical help?

If you experience severe headache, persistent vomiting, or inability to walk in a straight line, go to a clinic immediately. These are signs of HACE or HAPE, which are medical emergencies.

How to handle altitude sickness in Cusco

Prioritize hydration and rest for the first 24 hours while avoiding heavy meals and alcohol. If you are prone to altitude issues, ask your doctor for a prescription of Acetazolamide (Diamox) to start taking before you arrive in the city.

Acclimatize immediately. Upon landing, go directly to your accommodation and rest for at least 4 hours. Do not engage in strenuous physical activity or walking tours during your first full day.
Hydrate aggressively. Drink at least 3 liters of water daily. Skip the caffeine and alcohol entirely for the first 48 hours, as both are diuretics that will dehydrate you and exacerbate symptoms.
Use local remedies. Drink coca tea (mate de coca) offered by most hotels. It is a traditional and effective way to help the body process the thin air, but avoid over-consuming if you are sensitive to stimulants.
Eat light. Focus on high-carbohydrate, low-protein meals like quinoa or potato soups. Digestion requires significant energy and oxygen; heavy protein meals will leave you feeling sluggish and breathless.

Is it better to take a train or fly to Cusco?: Flying is faster, but arriving by bus from a lower altitude allows for better natural acclimatization. If you fly, be prepared to feel the effects immediately.
How long does it take to fully adjust?: Most people feel significantly better after 48 to 72 hours of steady hydration and low activity.
When should I seek medical help?: If you experience severe headache, persistent vomiting, or inability to walk in a straight line, go to a clinic immediately. These are signs of HACE or HAPE, which are medical emergencies.