Understanding Altitude Sickness: Inca Trail Safety Guide

by | Feb 3, 2024 | Peru Travel Blogs | 0 comments

Is The Inca Trail Hike a Dangerous Trip In Peru? Do you know how to treat altitude sickness along the Inca trail? read before traveling to Cusco and other hikes in Peru. With its stunning landscape, incredible Inca ruins, and challenging terrain, it’s no wonder why hiking the Inca Trail is such a sought-after experience. It is on many an adventurer’s bucket list. 

This ancient and cherished trail will take you up in elevation for four days of incredible breathtaking sights, sounds, and smells. You may wonder, “Is hiking the Inca Trail worth it?” For most people, the answer is a resounding “YES!”

As a seasoned Inca Trail Hiker and Tour Guide in Peru, I offer valuable insights on preventing challenges like altitude sickness, difficulty, and changing weather conditions. Let’s delve into these essential tips.

The altitude sickness on the Inca Trail is challenging, but the experience is truly rewarding.

While people at all fitness levels take on the challenge every year, it pays to be in decent shape before you tackle this gorgeous behemoth of a historic trek. It is a challenging hike, but hiking this paved Inca path is very well worth it. 

With all of the things, you may have read about how awesome, gorgeous, and historical the Inca Trail 4 days is, sometimes it’s hard to discern exactly how difficult it is to do this 4-day, 26-mile hike. Everyone is at different fitness levels. Don’t believe any of the Inca Trail sickness horror stories. The simple truth is, you do not need a great deal of physical stamina to do this hike! 

RELATED: Salkantay Trek 4 Days Altitude Sickness

The distance of the Inca Trail is about 42 kilometers or 26 miles in length. Over the four days, you will be ascending/descending roughly 2,000 meters (approximately 6,500 feet), with about 3,000 steps, going either up or down. The Inca Trail elevation is not bad; it’s completely doable. Essentially, if you are reasonably fit – that is if you exercise fairly regularly (walking, cardio, etc.), you can do this hike!  

IS The Inca Trail a Dangerous Hike For Altitude sickness?

How Challenging Is the Inca Trail Hike?

As a whole, the Inca hike is of moderate difficulty and easily within reach of hikers who are experienced in performing multiple-day hikes that include climbs and descents. It’s important to understand that you won’t travel the Inca Trip “as a whole,” but will do it one chunk at a time. You will find that various portions of the trail are very different from one another in length and nature. For example, you’ll finish at a much lower altitude than where you began.

The first day or two will be uphill rather than downhill. During the first couple of days of hiking, you’ll do the most demanding work while climbing from your trailhead to Dead Woman’s Pass, the highest point of the trail reaching 4,198 m (nearly 13,750 feet). Once you reach Dead Woman’s Pass, the most demanding portion of the trek is behind you, and it’s (mostly) downhill from there.

Aside from the sheer length of the Inca Trail hiking Trip, roughly 26 miles depending on the trailhead you depart from, and the exertion demanded of the most challenging early portions of the trail, the biggest challenge on the Inca Trail is the risk of altitude sickness. Most people begin to experience altitude sickness at roughly 2,400 m elevations. It’s essential to know that the entire Inca Trail lays beyond that threshold, and Dead Woman’s Pass, for example, is well beyond that point.

RELATED POST: Is The Inca Trail to Machu Picchu Hard?

What Exactly Is the Inca Trail Hike? –  How dangerous Is The Inca Trail?

While this iconic trail is by far the most popular, it is not the only one going to Machu Picchu. The Inca Path is part of an elaborate trail system devised by the ancient Incans that led to the old Empire of Tahuantinsuyo

This empire spanned much of Latin America. It dates back to the 15th century and was lost to the ages for hundreds of years. That is until it was “rediscovered” again by Hiram Bingham in 1915, during his expedition to find the legendary Lost City of the Incas. 

Today, the Inca Trail is one of the most well-known and well-hiked paths to Machu Picchu.

The journey culminates in the historic city of Machu Picchu – and makes for the best scenic end to four days of invigorating hiking. 

You will be trekking through the beautiful Andes Mountains. The trail itself consists of original Inca construction. Which has lasted over hundreds of years, and is proof of the genius of Incan engineering savvy, which has withstood the test of time. You will trek through the Alpine tundra, lush forests with heavy cloud cover, and two mountain passes. With panoramic views that you will not soon forget. 

Here Is a Guide to what you will experience on this epic 4-day Hike Day By Day. 

Day 1 – Easy to Moderate Training sessions to handle incline trail elevation.

The first day is relatively easy. For the first couple of hours you are hiking on mostly flat surfaces, but for the remaining 3-4 hours, you start the slow climb up to the first mountain pass. Expect to hike about 7-8 on this day. 

After a briefing from your guide, you begin your adventure at the trailhead KM 82, with spectacular views of the Andes Mountains. It is these mountains that the Inca paid homage to with ceremonies along the route.

The terrain is fairly flat for about 2 ½ hours until you reach the Inca site of Llactapata. At the end of this “easy” first day, you will reach camp for the night, and have a chance to relax before your busy second day.

Llactapata Inca trail
Llactapata – Picture by (Cesar Conde) – Tour Guide

Day 2 – Dead Woman Pass 4200m/Challenging and Dangerous for Altitude Sickness

The second day is the most difficult. For about 5 hours the hike will be a rigorous ascent to the first summit. The higher you go, the more altitude sickness may become an issue. Be sure to bring plenty of water and take frequent rests

It’s not a race! Due to the thinner air, your lungs will need more oxygen, which will manifest itself in shortness of breath and/or headaches. Your guide will tell you how to best deal with these on the trail.

Depending on your group tour’s itinerary, you cover either one or both mountain passes on this day. The 4-hour trek in the morning consists of some steep elevation gain and hundreds of ancient stone steps going both up and downhill.

But fear not, the views are well worth the workout, with lots of breaks to rest! Passing the meadow of Llulluchapampa, the trail ascends further through lush vegetation to Dead Woman’s Pass, aptly named the top of the mountain that resembles a woman lying down. It is the highest point of the trail, at 4,200 meters.

Dead Woman passes | up

Day 3 – Spectacular Scenery along this wonderful Inca stone-paved trail

Day three is easier in terms of terrain, but generally, it is a longer hike. And you are rewarded with even more spectacular views and varying landscapes that keep you enthralled the entire day! It is here that you begin descending through cloud-covered forests, incredible ancient ruins, and wide-open vistas that go on forever.

This is a very scenic day, as you will pass through the Inca site of Runkuracay, overlooking the Pacamayo Valley, and Abra de Runkuracay, at an elevation of 4,000 meters. You will traverse over the original stone steps laid by the Inca people hundreds of years ago.

Next is the ruins of Sayacmarca, meaning “inaccessible town”, and protected on two sides by cliffs. Another nice spot is the small Inca dwelling of Conchamarca. One of the highlights is the ruins of Phuyupatamarca, or “town in the clouds”, as you pass through lush forests to the next campsite.

This is by far the most beautiful scenery you will experience on the Inca Trail. You may hear tales of the “Gringo Killer,” which are steep steps you will be descending that can be a bit hard on the knees! For this, carrying a walking stick is a good idea. Expect to hike for about 7 hours on this day. 

hiking guide Peru and Macbu Picchu Trail
Winayhuayna Agricultural Terraces | Simply Gorgeous View

Day 4 Short Hiking Day – Unique and Moving

You are almost there! Today’s final, the short hike ends with a fun but challenging sharp ascent up 50 stone steps. Warmly named the “Monkey Climb.” At the top, pass through the Sun Gate to Machu Picchu and your final destination, the incredible ancient city laid out in all of its grandeur! You will feel a profound sense of awe and accomplishment from the beauty and challenges of the last four days. Finally, your guide will tell you all about this great city, with time for you to explore on your own.

All along the Inca Trail. You will be met with surroundings teeming with wildlife, and don’t be surprised if you encounter several llamas in the fields and on the Inca Trail. This also means that when you do reach the top, you will be generously rewarded with unbelievable views of the landscape!

How to Prevent Altitude Sickness Before hiking the Inca Trail?

The most common symptoms of altitude sickness are shortness of breath and potentially severe headaches. How can you prevent or reduce the risk of harmful altitude sickness?

The most effective way to prevent altitude sickness is to acclimatize to the higher altitude and lower available oxygen. The most significant way to do that is to spend time in the increased elevations before beginning the exertion, such as embarking on the Inca Trail. Trailheads for the Inca Trail depart from near Cusco’s town, where you may fly before your trek. Cusco Elevation lies at approximately 3,339 m above sea level. 

Before beginning your hike, we recommend that you spend a couple of days in Cusco before beginning the hike. Another alternative location to spend some time acclimating is the village of Arequipa at 2,328 m elevation.

Better yet, spend a couple of days in Arequipa before progressing to spend a couple of additional days at Cusco, before starting your Inca Trail trek.

The staff at Tour Leaders Peru are highly experienced with trekking and understanding altitude sickness symptoms and risks. They’ll take all appropriate actions to monitor your health and to respond to any emergencies. In addition to the essential recommendation to acclimatize, here are a few simple tips for preventing altitude sickness:

  • Climb at a slow pace with only moderate elevation gains in any single day.
  • Since you’ll burn more calories at high altitudes, eat lots of carbohydrates.
  • Don’t drink alcohol, smoke cigarettes, or take sleeping pills that can all make your symptoms worse.
  • Drink lots of water.
  • When possible, retreat from your highest obtained altitude to sleep at a lower altitude.

Ask your physician about whether it’s appropriate to take the prescription medication acetazolamide a couple of days before your trip to help prevent altitude sickness.

Is The Inca Trail to Machu Picchu Dangerous

More Tips on How To Prevent AMS Hiking in Peru

Follow these four steps to attenuate your risk of AMS:

  1. ‘Walk high and sleep low’
    All of Machu Picchu’s routes are pre-planned to offer you the simplest acclimatization opportunities and to permit you to sleep at a lower elevation than you’ve been at for many of the day.
  2. Take some time
    If you’re breathing too hard to simply have a conversation, you’re putting yourself in danger. Slow things down and take a number of the strain off your heart and lungs.
  3. Drink much more water than you think you would like or are comfortable with
    Dehydration not only compromises acclimatization but it is often confused with AMS also. Avoid both by drinking 3 liters of water every day at the very least.

If your wee is yellow, you’re in peril of dehydration. If it’s orange you’re already dehydrated. Drink more immediately. Also, bring a wee bottle to bed, unless you enjoy freezing night-time strolls to the toilet.

IS The Inca Trail a Dangerous Hike For Altitude sickness?
Ask in Spanish Soroche Pills For Altitude Sickness

Inca Trail: Diamox Usage and Side Effects for Altitude Sickness

Almost everyone has an opinion about whether or to not use Diamox. (Just Google it, you’ll see.) Overall, the research shows that it helps avoid AMS if used correctly. it’s though, a prescription and you ought to not decide whether or to not use it without consulting your doctor.

The biggest danger about Diamox is that some people insist upon thinking of it as a cure, or proof against AMS. A couple of climbers have ignored serious AMS symptoms, thinking themselves protected by Diamox, and are available to grief. the straightforward truth is that if you get symptoms you almost certainly have AMS and you want to get to a lower altitude immediately. Diamox doesn’t ‘fix’ AMS, but it does speed up acclimatization, which may avoid AMS entirely.

To be effective, you would like to start out taking Diamox a couple of days before rising to high altitudes. Most experts recommend 125 to 500mg daily. We recommend half a 250mg tablet before bed, and another within the morning. (Again, ask your GP first.)

Diamox does have some side effects, but the common ones are quite mild. It can make your fingers and toes tingle or feel numb. It causes really frequent urination (on top of the three liters of water each day, you’ll notice it). Perhaps the worst is that it makes beer (or anything fizzy) taste awful. the great news is that it all wears off quickly, and if you stop taking Diamox once you get to Machu Picchu, you’ll enjoy a well-earned beer in Cusco.

quarry trail Peru To Machu Picchu
Inca quarry trail Peru

Pro Machu Picchu Hiking Guide and Tips:

  • Book your tickets and arrange for your permits well ahead of time. There are only a limited amount of park entrances each year, and they tend to sell out quickly. 
  • You must get an Inca Trail to permit, and Inca Trial tickets to do this hike. Go here for some good information on permits. 
  • Choose a good trekking company to hike with. Read their reviews and choose an itinerary that best suits you. 
  • To best acclimate yourself to the higher elevations, spend 2-3 days in the town of Cuzco nearby, which is at an altitude of 2,328 meters.  
  • To help combat any Inca Trail altitude sickness, avoid eating or drinking anything that could upset your stomach in the days before doing the Inca Trail. 
  • For altitude sickness on the trail, consider taking along some coca leaves. This stimulant, while banned in other countries, is widely available in Peru. 
  • Trekking poles are your friend! Don’t be afraid to use them, although they are not required. There is nothing technical about the hike, but going up and down all of those steps can put a strain on your knees. 
  • Carry a day pack. Your backpack should ONLY carry the essentials. Let the porters carry the heavy stuff! 
  • If you can, avoid the Inca Trail high season of July and August. During this time, many people will want to hike it and you don’t want to get caught with the crowds. It will lessen your experience. 
  • Instead, go during Inca Trail’s low season of May and October. Here, the weather is still nice and permits will not sell out as quickly. 
  • Research the Quechua history before your trip. Your guide will no doubt tell you a lot about the history of the region and how Machu Picchu came to be. But it helps to have a good background of it going in beforehand. It’ll enrich your entire experience. 
  • You can bring your camera on the trail but don’t have it out constantly. You will want to live in the moment and take in all of the scenery with your own eyes! Completely immerse yourself in the trail. Limit yourself to about a dozen landscape shots and panoramas.

Hiking the Inca Trail can be one of the most rewarding experiences you will have in your lifetime. So what are you waiting for? Start planning your epic trip to the Inca Trail and Machu Picchu today and don’t forget How to deal with high altitude sickness- The Inca Trail follows our recommendations.

Sun gate Machu Picchu
Sun Gate

Is Hiking The Inca Trail in Peru Dangerous?

The Inca Trail in Peru can be dangerous, especially during the rainy season. The most common threat on the trail is landslides, which can occur due to heavy rains and high mountains in the Andes.

The months of January, February, and March are particularly prone to intense rainfall in Cusco. However, despite this potential danger, the Inca Trail is generally considered a safe route for hikers.

Hikers need to take proper precautions and be aware of weather conditions before embarking on the trail. It is also recommended to hike with a guided tour or an experienced local guide who knows the area well and can navigate any potential dangers.

Overall, while there are risks associated with hiking the Inca Trail, it remains a popular and relatively safe destination for adventurers.


Thank you for delving into my article on ‘Inca Trail Altitude Sickness’! Life offers no certainties, yet don’t let that deter you from embarking on this extraordinary trail, forging fresh and enduring memories.


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Cesar Conde

I’m Cesar Conde Licensed Tour Guide in Peru, owner of Tour Leaders Peru and Travel Advisor. My other side job is a Digital Nomad. I share my amazing travel experiences, stories, guides, and itineraries for travelers like you and me!


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