If you’re planning to take on the Salkantay Trek or the Inca Trail, preparing your body for the altitude is just as important as packing the right gear. Cusco sits at around 3,400 meters (11,150 feet), and both treks climb even higher — the Salkantay Trek reaches 4,700 meters at its highest point, while the Inca Trail peaks at around 4,200 meters at Dead Woman’s Pass. Giving your body time to adjust gradually is the single most effective way to reduce the risk of altitude sickness, also known as soroche in the Andes.

Where to Stay Before Your Trek

One of the smartest strategies is to avoid sleeping in Cusco on your very first night after arriving from sea level. Instead, consider spending your first one or two nights in the Sacred Valley, where towns like Urubamba and Ollantaytambo sit at a noticeably lower elevation (around 2,800–2,900 meters) compared to Cusco. This allows your body to begin acclimatizing more gradually before you move up to Cusco’s higher altitude and, eventually, the trek itself. Avoiding a sudden jump from low altitude to a high sleeping elevation in a single day is a widely recommended approach for safer high-altitude travel.

What to Do Before the Trek

Try to arrive in the Cusco region at least 2 to 3 days before your trek begins, and use this time wisely. Rest as much as possible, stay well hydrated by drinking plenty of water throughout the day, and stick to light, easily digestible meals, especially during your first 24 to 48 hours at altitude. It’s also best to avoid alcohol during this initial period, since it can worsen dehydration and mask early symptoms of altitude sickness. Rather than diving into strenuous activity right away, ease into it: short, gentle walks around town, a relaxed visit to nearby ruins, or a low-effort tour like the Sacred Valley Tour are great ways to stay active while your body adjusts. Many travelers also find that coca leaf tea, a traditional Andean remedy, helps ease some of the discomfort associated with the altitude change.

Recognizing the Symptoms

Even with good preparation, it’s important to know the early warning signs of altitude sickness so you can respond quickly if needed. These include headaches, nausea, dizziness, unusual fatigue, shortness of breath even at rest, and difficulty sleeping. Mild symptoms are common and often improve within a day or two as your body adjusts. However, if symptoms worsen or don’t improve with rest and hydration, the recommended course of action is to descend to a lower altitude — in many cases, dropping just 300 to 1,000 meters can make a significant difference in how you feel.

Medication and Extra Precautions

For travelers at higher risk of altitude sickness, or for those who can’t follow a gradual ascent schedule, acetazolamide (commonly known by the brand name Diamox) is a medication often used as a preventive measure. The CDC notes that it can be a helpful option in these situations, though it should always be taken under medical guidance, particularly if you have pre-existing health conditions or take other medications regularly. We recommend consulting your doctor before your trip to determine if this is a good option for you.

Final Recommendation

Successfully enjoying the Salkantay Trek or Inca Trail comes down to respecting the altitude and giving your body the time it needs to adapt. A solid acclimatization plan, proper hydration, light activity in the days leading up to your trek, and awareness of warning signs can make all the difference between an uncomfortable start and a truly unforgettable adventure in the Peruvian Andes.