Prepare for Altitude Changes in Advance

Ecuador's diverse geography means you can go from sea level at the coast to over 2,800 meters (9,000+ feet) in cities like Quito within a single day.

Altitude sickness is real and can catch travelers off guard, especially if arriving directly into high-elevation cities without acclimatization. Symptoms include headaches, nausea, dizziness, and fatigue.

To minimize discomfort, plan to spend your first 1–2 days in Quito or other highland cities, taking it easy — avoid strenuous hikes, heavy meals, and alcohol. Stay well hydrated (without overdoing it), and consider bringing altitude medication like acetazolamide if you're prone to issues. If symptoms worsen, head to lower elevations.

Hotels in Quito often provide oxygen tanks for guests, and coca tea is a popular natural remedy used by locals (ask before drinking it if you’re sensitive to stimulants).