Salkantay Trek emergency & health guide: altitude, hospitals, rescue and Machu Picchu rules

Emergency numbers

There is no mountain rescue on the Salkantay Trek and almost no phone signal between Soraypampa and Collpapampa. Guides and camp families carry oxygen and first aid and can bring horses to the road; a helicopter is only possible through private travel insurance, so check that yours covers trekking to 4,700 m and evacuation. Spend at least 2 to 3 days in Cusco before you start, and go down at once if you have a bad headache, vomiting, confusion or breathlessness at rest.

Rules to know

• No permit or quota is needed for the Salkantay Trek, and you may walk it without a guide. Communities charge small cash fees, for example about PEN 30 for foreigners at Humantay Lake. Carry small notes in soles.
• Machu Picchu tickets are sold only at tuboleto.cultura.pe, plus up to 1,000 tickets a day sold in person in Aguas Calientes for the next day. Since September 2026 there is no reservation step: choose date, circuit, route and entry time and pay within 15 minutes. The ticket is linked to your passport, cannot be transferred and the time cannot be changed.
• Machu Picchu has 3 circuits with 10 routes: Circuit 1 Panoramic (Machu Picchu Mountain, Upper Terrace, and Inti Punku and Inca Bridge in high season), Circuit 2 Classic (the full classic tour, sells out first) and Circuit 3 Royalty (Huayna Picchu, the lower sector, and the Great Cavern and Huchuy Picchu in high season).
• From 1 May 2026 an adult foreigner pays PEN 163 (press reports); children and students with a university card pay less. Up to 5,600 visitors a day are allowed on peak dates (19 June – 2 November 2026) and 4,500 on other days.
• You have 30 minutes after the entry time on your ticket (45 minutes in high season) to reach the gate; after that you cannot enter, and there is no re-entry.
• Inside Machu Picchu: no bags larger than 40 x 35 x 20 cm, no food, no trekking poles, umbrellas, tripods or selfie sticks, no hard-soled shoes, no drones, no smoking or vaping. Leave your trekking pack and poles at your hotel or at the luggage store by the entrance.
• Altitude: you sleep at 3,900 m on the first night and cross about 4,630 m on day 2. Acclimatise in Cusco or the Sacred Valley for 2 to 3 days, drink plenty, and do not go higher with symptoms of altitude sickness.
• Weather: frost at night from May to September, daily rain and mud from December to March, and snow on the pass in any month. In the wet season operators may replace the Llactapata route with the valley road to Hidroeléctrica.
• Water: streams are used by horses, mules and alpacas. Filter or treat all water, or buy boiled water at the camps, and carry out your rubbish.
• Transport: from Hidroeléctrica walk about 2.5 hours along the railway or take the 30-minute train to Aguas Calientes (book ahead). The Consettur bus goes up to Machu Picchu in about 25–30 minutes; trains return to Ollantaytambo and Cusco.

Nearest hospital for each stage

Hospitals

Health centres and clinics

There is no clinic on the high section. The nearest health centre below Soraypampa is in Mollepata; on the jungle side there is a small pharmacy at La Playa and a health centre in Santa Teresa. In Aguas Calientes the public Centro de Salud Machupicchu is open 24 hours and O2 Medical Network runs a private travellers' clinic with a hyperbaric chamber (+51 84 221213, 24/7). Serious cases are taken to Cusco.

Pharmacies, cash and supplies

• Pharmacies: Aguas Calientes
• ATMs: Aguas Calientes
• Shops: Chaullay, Aguas Calientes
• Bus and train stops: Chaullay, Aguas Calientes

There is no pharmacy between Mollepata and La Playa. La Playa has a small pharmacy and Aguas Calientes has several, one of them open 24 hours. Buy altitude medicine (ask a doctor about acetazolamide), rehydration salts, a blister kit and strong insect repellent in Cusco before you start. Camps have little power: carry a power bank.

Pharmacies, ATMs, shops and stops: © OpenStreetMap contributors. Hospitals and health centres checked online.