Machu Picchu is at 2,430 metres (7,970 feet), which sounds high until you learn that Cusco, where you’ll probably sleep the night before, sits almost 1,000 metres higher at 3,400 m. The citadel itself is the easier end of the altitude curve on a Peru trip.
The trick is to acclimatise in Cusco first. Two nights minimum, three if you can spare them. The second day is usually the worst for altitude sickness, so arrange the Machu Picchu train for day three or later.
Symptoms to watch for: headache, poor sleep, shortness of breath, mild nausea. Drink more water than feels sensible, skip alcohol, eat light, and keep sorojchi pills in your bag.
At the citadel, the terrain does the work your lungs are not quite ready for. The stair sections — especially up to the guardian’s hut viewpoint — are where most people feel it.
If you’d rather have the pacing built in, Peruways can bundle the Cusco nights, trains and timed-entry ticket.
