Will I get altitude sickness in Cusco?

It's common for most people who are coming from sea level to experience at least mild symptoms of altitude sickness when they arrive in Cusco, which is 11,000 ft/3430 m above sea level. Symptoms vary from person to person, but can include:
-headache (the most common complaint)
-nausea
-insomnia
-fatigue
-loss of appetite

The best natural remedy is to drink plenty of water before you arrive at altitude and continue to drink water even at night. Coca leaf tea is available in every hotel coffee bar and restaurant. There is no way to predict if it will alleviate your symptoms. The most reliable treatment for headache is to bring your own treatments. Ask your physician about prescription treatments before you travel.

Is it safe to drink the water in Peru?

Tap water in Lima, Cusco and other larger cities is consumed by local people every day.  But is it safe for you?  There's only one way to find out and we suggest that you not drink the tap water or use it to brush your teeth. Bottled water is cheap and available everywhere including small towns and villages.
We support the reduction of the use of disposable plastic water bottles and encourage you to bring a purification device to make your own safe drinking water. The device should be rated to purify water from microbes and viruses, not just for taste. We found a small, inexpensive passive portable water filter that removes not only bacteria, but heavy metals and inorganic materials like chlorine, nitrite and fluoride. Here is a link to read more, and a discount code if you choose to buy it. Drivers may carry purified drinking water to refill your personal water bottle on day tours and activities.

What is the best way to travel between Lima and Cusco?

We recommend flying 1 hour/20 minutes between the cities because other means require more time or are not practical for short vacations. There is no train service between Lima and Cusco.  And while there is bus service, the drive is almost 24 hours long over paved, and winding mountain roads. There is no speedy highway. We recommend that you book Latam Airlines for the most reliable airline service. And we suggest you allow at least 4-5 hours layover in Lima airport if you intend to fly from Cusco to Lima for an international connecting flight on the same day. 

Where should I stay if my international flight arrives in Lima in the evening?

There is only one hotel at the Lima airport.  The Wyndham Hotel is connected to the arrivals terminal by a skybridge on the 2nd floor or by crossing a 3 lane road on the ground level.  It takes literally 2 minutes to walk from the terminal to the lobby of the hotel. 

This hotel is best for groups who arrive in Lima in the evening and plan to depart again by air the next day. For groups planning to stay in Lima, it's best to ask your hotel in the Lima city center to arrange a ground transfer, since there are no shuttle buses.  The travel time is about 45 minutes each way when the traffic is moderate. Traffic can be routinely congested during the daytime, from 7AM to 8PM.  The cost ranges from $35 USD each way and up.  If your group is larger than 3 persons, you may need a transfer in a mini-van or two taxis. 

Do I need vaccinations to visit Machu Picchu?

No. Covid vaccinations are not required to enter Peru. And other travel vaccinations are not required. The altitude of Machu Picchu is 8000 ft/2440 m and higher.  Disease-carrying vectors do not thrive at higher elevations. US citizens are not required to get Yellow Fever vaccinations or prophylactic Malaria treatments.  Although there have been no recent cases of Yellow Fever in Peru, some countries, including the US, recommend that visitors get Yellow Fever vaccinations prior to visiting the Amazon Rainforest, including Tambopata Reserve or Manu National Reserve. Even though these vaccinations are not required to re-enter the US, they may be required if you are transiting or traveling to another country before you return home. We recommend that travelers check the regulations for re-entry for any countries they will pass through after leaving Peru, Bolivia or Ecuador. Health regulations are subject to change from time to time. It is the responsibility of travelers to consult their own government health departments or tropical medicine clinics for up to date and relevant information.